Billing for 99401

[javed0076]

Can anyone please let me know how to bill CPT 99401??  Is this CPT billable with OV E&M code?? Also let me if any modifier need to use.

[Michele]

Are you a coder or a biller?  If you are a biller then you shouldn't be trying to code without training and/or the patient's chart.  Not trying to be harsh, just trying to protect you.  You can get into trouble if you code it incorrectly.  Anyway with that being said, the 99401 Preventive medicine counseling/risk factor reduction, 15 minutes, is billed just as any other CPT, with the dx that is relating to the service.  If the provider also did an OV, then them appropriate E&M, again with the relating ICD code can also be billed.  When an E&M is billed in addition to another service and the E&M is separate then modifier 25 can be used to indicate that the E&M is separate.

[javed0076]

Hi Michele,

Thank You for help, We are using EMR software so provider is just selecting CPTs and ICD, we need to check is it billable or not or those CPTs need modifier or not. So you can me biller and coder both... 

Provider is using E&M code with 99401/2. In this case we are using E&M CPT with 25 modifier and 99401/2 (with V code DX) with 59 modifier.