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Modifier inquiry (RHFMC)

Chuck Posted Wed 19th of February, 2014 12:40:33 PM

We submitted the following codes to Medicare:
99213 Follow up office visit
81002 Urinalysis
J1885 Ketorolac
96372 Administration of injection

The 99213 code was rejected because of lack of a modifier. What modifier would you suggest that I use?
Thank you!

SuperCoder Answered Thu 20th of February, 2014 13:50:03 PM

Don’t forget to report the E/M service with 99201-99215 (Office or other outpatient visit for the evaluation and management of a new or esta++blished patient) and the injection administration with 96372 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular). Modifier 25 (Significant, separately identifiable evaluation and management [E/M] service by the same physician or other qualified healthcare professional on the same day of the procedure or other service) on the E/M code is not necessary, but may be required by some payers.

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