Author Topic: PPD NEED HELP..  (Read 1345 times)

djk

  • Newbie
  • *
  • Posts: 43
PPD NEED HELP..
« 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

RichardP

  • Hero Member
  • *****
  • Posts: 688
Re: PPD NEED HELP..
« Reply #1 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?

djk

  • Newbie
  • *
  • Posts: 43
Re: PPD NEED HELP..
« Reply #2 on: August 04, 2015, 10:18:47 AM »
I'm not, i cant find the right code for it.

lpfamilyphys

  • Newbie
  • *
  • Posts: 9
Re: PPD NEED HELP..
« Reply #3 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.  :) :) :)

djk

  • Newbie
  • *
  • Posts: 43
Re: PPD NEED HELP..
« Reply #4 on: August 11, 2015, 07:04:56 AM »
Thank you for your help