Author Topic: coding question family practice  (Read 995 times)

MFunk

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coding question family practice
« on: March 01, 2012, 11:26:38 AM »
I have a new provider and he has been billing 99213 routine office visit with 11056 (paring and cuttin)
Second code is deniey as incorrect modifier or modifier missing. I see where the cliam was submitted w/ a modifier placement 99213 (25) 11056 (59)
It has also been sent w/o the modifier 59.
What is correct? How should I been sending this claim out for payment? Thanks!

koatsj

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Re: coding question family practice
« Reply #1 on: March 01, 2012, 11:33:36 AM »
If the documentation supports the need to bill an office visit with the procedure code, you need to add -25 modifier onto the e/m. You don't need modifier -59.