Medical Billing Forum

Billing => Billing => : rlopez32 December 16, 2011, 08:22:53 PM

: Procedure during office visit
: rlopez32 December 16, 2011, 08:22:53 PM
Hello Everyone
I have a pediatrician who removed something from a child's nose and I billed 10120 but also billed the office visit 99213. The ins applied the whole charge of the 10120 to the patients deductible and didn't cover the office visit as it was incidental to the procedure performed. Is there a modifier I need to bill to have them pay for the office visit also?
: Re: Procedure during office visit
: PMRNC December 16, 2011, 09:33:10 PM
Ah the joys of the easy removal of pea's from kids noses..   The OV is supposed to be bundled with the procedure. I'm assuming they didn't just see the thing up his nose while going for some other reason?
: Re: Procedure during office visit
: SLITTLES December 16, 2011, 10:18:19 PM
If the office visit was separate from the procedure, you can append mod 25 to the 99213, however if the reason for the office visit was for something in the kids nose, then no you shouldn't add a modifier.