Medical Billing Forum

Billing => Billing => : PMBS December 28, 2017, 03:50:55 PM

: preventative
: PMBS December 28, 2017, 03:50:55 PM
What modifier would you use on the 99396?

99396
90471
90674

I used a modifier 59 and insurance denied the claim.

Any help will be appreciated.
: Re: preventative
: kristin December 28, 2017, 04:46:37 PM
59 modifiers are never to be used on E/M codes such as 99396. They are for procedures. You need a 25 modifier on the 99396, to show that the preventative service was separate from the vaccine at the same visit.