May we get paid for cpt 99173 with any modifier.

Hello.

It is bring to you that the CPT 99173 is always rejecting as non covered service for providers. Can you suggest any modifier for getting paid from the Commercial Insurance to this CPT Code.


Thanking You,
With Regards
Shreekanth.

It is actually a bundled service

Kind of like charging separately for a blood pressure with a visit for Hypertension. The visual acuity test is an integral part of a visit for a sports Physical, eye complaint, etc. and is not paid separately. The equipment costs are minor and the time required is minor so IMHO it is not unreasonable.

99173

CPT commentary is that it is separate and distinct and should be paid separately, but the payers all bundle it, as signaturedoc says.

It is a contracting issue: you can't appeal them one by one. If you really want to get paid for it, try negotiating with your payers.