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Hi Cindy,
The billed codes with modifiers seem correct. However, with the patient condition like diabetes mellitus, routine procedures are covered only if the patient is under the active care of a doctor of medicine or osteopathy who documents the condition. So you also need to submit these details as well and check payer policy as well. Also check with the below provided link and with your documentation for further clarification. For more clarity you can send us with some more details of your documentation. Thank you.