Medical Billing Forum

Billing => Billing => : DaveMoody September 22, 2016, 10:54:47 PM

: Submitting an office visit and a preventive visit to Maryland Medicaid
: DaveMoody September 22, 2016, 10:54:47 PM

Anytime I submit an office visit and a preventive visit done on the same day to Maryland Medicaid, they always end up denying the office visit, despite the fact that I appended modifier 25 to the office visit.

Is there supposed to be a modifier appended to the preventive visit as well? Or is there another modifier that's supposed to be appended to the office visit instead of modifier 25?

: Re: Submitting an office visit and a preventive visit to Maryland Medicaid
: kristin September 22, 2016, 11:34:09 PM

I don't know about Maryland Medicaid's rules, but I do know that other insurances simply will not pay for the separate office visit. Especially since ICD-10, and the coding guidelines concerning this.

Many offices are unfortunately having to make the patient come back for the preventive visit, since it can't be billed the same day as a "problem visit".

You really need to call Medicaid, and get their stance on this.