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Should I append modifier 59 and any other modifier if I have this.....

obinna Posted Wed 17th of June, 2015 16:25:26 PM

99214 (Modifier 25)------75289, 367.9
99393------------------------V20.2
99173------------------------V20.2
36415------------------------278.00
69210------------------------380.4

Which CPT codes should I append modifier 59 to (36415 or 69210)? If I append modifier 59 to 69210, would I have to append another modifier to 36415? Or can I append modifier 59 to both 36415 or 69210?

SuperCoder Answered Thu 18th of June, 2015 03:52:21 AM

First of all, the correct order of codes (in decreasing order of RVU) is:

99214
99393
69210
99173
36415

As per CCI, 99214 is a col. 2 code to 69210 (col. 1 code).

Check your documentation. If the EM service (99214) is a separately reportable service, then bill 99214 with mod. 25. Other codes are not bundled with each other, so no modifier is required.

However check your payer policies for multiple procedure billing. If required append mod. 59 and 51 with secondary onwards procedure codes.

SuperCoder Answered Thu 18th of June, 2015 04:39:38 AM

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