Medical Billing Forum

General Category => General Questions => Topic started by: grg61458 on January 08, 2016, 04:54:37 PM

Title: chiropractic and tx
Post by: grg61458 on January 08, 2016, 04:54:37 PM
I'm a new biller fresh out of school, I'm billing 99203 or 99214 for eval with mod 25, and 3 cpts tx codes 97110 97112 97150, I'm I to use modifier 25 on all cpt lines or just the eval line 1. received first payment, appears only line one was paid eval was paid.
Title: Re: chiropractic and tx
Post by: kristin on January 08, 2016, 11:32:23 PM
If you read the guidelines on modifier 25, you will see that it is only used on E/M codes. See here:

http://www.wpsmedicare.com/j8macpartb/resources/modifiers/modifier-25.shtml

If I am understanding your post correctly, you are not being paid for 97110, 97112, and 97150, but only for the E/M code. The reasons for this can be numerous...if you want help on that, you need to elucidate on the denial, including what insurance was billed, dxs used, etc.