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90911 & 97032

David Posted Thu 19th of March, 2015 15:42:39 PM

We are billing for Biofeedback 90911 and 97032 for the same visit. We have the 59 modifier on the 97032. Both were done and SuperCoder states that a modifier can be added. We have a Medicare plan not wanting to pay for the 97032/59 stating that the modifier is in appropriate. What can we do to get this paid?
Thank you

SuperCoder Answered Fri 20th of March, 2015 06:09:50 AM

CPT code 97032 is considered included in CPT code 90911. However, there are certain scenarios where we can get this code paid by appending 59 modifier to this code. Documentation must support electrical stimulation separate from the use of biofeedback. A staff member must be present for the entire session to use this code. If your documentation supports that electrical stimulation was separate from the use of biofeedback, then your service should get paid.

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