E/M code 99214 and 20605 code

I would like to know if somebody can help me in this matter.
The doctor use the code 20605 for a TPI injection/ bilateral.
Office visit code 99214. The insurance only paid for the single 20605.
What type of modifiers I need to use to resubmit this claim and get paid for the office visit.

Thanks

Maria

re: E/M code 99214 and 20605 code

my question to you is was the patient scheduled for the injection or was the visit a new complaint and was scheduled for a office visit which lead to the provider doing the injection. If the patient has a history of the present illness and has already been seen for the complaint and the provider has the patient on scheduled injections, he should not be charging for the office visit, only the injection. If the patient is presenting for a new problem and the provider did the injection during the initial visit then you would add the modifier 25. Per your note this is an established patient, so I'm not sure if he should be billing out for the E&M level that he is billing. that level of visit is for a medical decisoin making of moderate complexity with a detailed history and exam. again i state if the patient has been previously seen for the presenting problem then no office visit should be billed unless the patient is presenting with a new problem.

re: E/M code 99214 and 20605 code

I would agree with that. Typically if the patient has a history of getting the injection, and is coming back for another one, it's hard to justify the E/M unless there is a whole other problem being addressed.