Medical Billing Forum
Coding => Coding => : djk July 28, 2015, 10:36:31 AM
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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
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99213 is an evaluation and management (E/M) service code. What CPT code are you using for the actual PPD test?
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I'm not, i cant find the right code for it.
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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. :) :) :)
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Thank you for your help