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when and what modifier do I use when billing out

SuperCoder Posted Tue 23rd of August, 2011 01:29:12 AM

99214, 99000, 94760

SuperCoder Answered Tue 23rd of August, 2011 17:28:02 PM

99214-25, 94760, 99000

SuperCoder Posted Tue 23rd of August, 2011 19:27:44 PM

Sanjit,
Thank you much for you help on this, VA MCD is bundling the 99000 and denying the 94760 (Non-covered service), we are billing out the 99214 with the modifier 25. Has anyone had any luck with getting this paid.
Thanks again for your help.

SuperCoder Answered Tue 23rd of August, 2011 20:57:57 PM

For many Insurances, particularly MCD:
CPT 99000 will not be separately reimbursed when submitted with the following CPT codes:
11100 80050 84443 99204 99385 99395
36410 80053 85018 99211 99386 99396
36415 80061 85025 99212 99387 99397
57454 81002 88142 99213 99392
58100 82948 88175 99214 99393
80048 83036 99203 99215 99394

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