Medical Billing Forum

Coding => Coding => Topic started by: djk on July 28, 2015, 07:36:31 AM

Title: PPD NEED HELP..
Post by: djk on July 28, 2015, 07:36:31 AM
I am trying this topic again, i cant seem to figure out how to get a PPD test paid.. I am billing a 99213 with the DX V74.1 and it gets denied for non-covered services
Title: Re: PPD NEED HELP..
Post by: RichardP on July 28, 2015, 02:23:20 PM
99213 is an evaluation and management (E/M) service code.  What CPT code are you using for the actual PPD test?
Title: Re: PPD NEED HELP..
Post by: djk on August 04, 2015, 10:18:47 AM
I'm not, i cant find the right code for it.
Title: Re: PPD NEED HELP..
Post by: lpfamilyphys on August 05, 2015, 10:20:52 AM
You need to have modifier 25 on the E/M code and then you will have to have modifier 59 on the admin code for the injection.  They are bundling this with the E/M code.  So if you are seeing a pt for 99213 for some other reason and then in the midst of the visit the provider finds out they need a PPD.  The claims will look like this:

99213 25 (whatever the DX is)
86580       V74.1
96372 59  V74.1

This should get the claim paid.  I have been filing all of our vaccines/PPD/injections this way and I have not had a problem.  I hope this helps for you.  :) :) :)
Title: Re: PPD NEED HELP..
Post by: djk on August 11, 2015, 07:04:56 AM
Thank you for your help