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Re: billing 99354

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best biller:
i would like to know with which modifier 99354 she be billed. ins denies incorrect modifier
thanks in advance

Michele:
There is no way to know without more info.  Also, I hate to sound like a broken record but it is not OK for a biller to simply change a modifier to get the claim paid.  Modifiers are part of coding and in order to code you must have access to ALL of the information.  But even based on your question you don't say what modifier was on it that was denied.

Need way more info.

best biller:
modifier 59

Michele:
If you are using 59 modifier then there must be other codes on the claim?

shanbull:
Was this billed with an E&M code too? In that case the modifier would need to be on the E&M code rather than the additional service. And I would not use modifier 59. Here's why: http://www.poweryourpractice.com/revenue-cycle-management/modifier-59-25-91-guide-coders/

Usually for E&M services with extra components we're talking about an additional service for a condition that requires extra diagnostic or counseling time, not an additional body part. Modifier 59 is used to identify a service performed on a different body part than the main examination covered. If this does not apply, you should not use modifier 59.

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