Billing > Billing
Re: billing 99354
best biller:
i used modifier 25 on the 99214 and 59 on 99354
shanbull:
I would just delete the 59 modifier and resubmit the claim, the modifier 25 on the E&M is sufficient to separate the two services.
best biller:
i tried that for a different patient and it didn't work either
shanbull:
--- Quote from: best biller on February 24, 2014, 03:11:50 PM ---i tried that for a different patient and it didn't work either
--- End quote ---
What insurance company is this for? I just looked through the Medicare publication about this and your CPT's should be fine to bill together and both be paid. Your exact scenario is in this coding example as well: http://www.findacode.com/articles/prolonged-evaluation-and-management-em-services-99354-99355.html
So at this point I'm thinking maybe it's the insurer that has special rules? Because from a coding standpoint, what you're submitting is correct as far as I can tell, unless I'm missing a crucial detail here.
dermbillerPA:
It is my understanding that NO modifiers are required if your billing 99214 with 99354.
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