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Pulmonary function test

Cherie Posted Wed 30th of November, 2011 15:04:27 PM

When billing for a pft, are you having to use a 25 modifier on the ov and a 59 with the 94060? I never have used any modifiers, I always billed 99213 94060 94240 94720. Never have used a modifier. All the sudden I get a letter from Medicare, taking money back, saying I have not used correct modifiers. I have now been told by other billers, the use the 25 and 59 modifier. Anyone else had this problem? Anyone else use modifiers w pft?

SuperCoder Answered Wed 30th of November, 2011 15:49:22 PM

You can bill the E/M with modifier 25 as well as the PFT when the patient was scheduled for the PFT, when the patient was also evaluated for a separate problem and that problem was also treated and managed.
Additionally, I think you should have billed CPTs 94060 94240 94720 with modifier 26 on each.

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