Forum - Questions & Answers

Oct 11th, 2011 - gloria84

Help!!! with 99385 and 96372

My patient came in for E/M, preventive, injections, and injection administration.
All of the above were billed. Now the insurance company is stating that 99385 which is the well visit and 96372 injection administration are bundled!!! Therefore they only paid the E/M injections and administration... I need to get the 99385 paid, Im I missing a modifier??? please help.... Note: I did use the 25 modifier already for the E/M.

Oct 11th, 2011 - Codapedia Editor 1,399 

re: Help!!! with 99385 and 96372

What did you inject?

Oct 11th, 2011 -

re: Help!!! with 99385 and 96372

How about your diagnosis codes for each CPT®? Did you put a V code on the preventive exam and a problem code on the other one

Oct 12th, 2011 - billingsvc 4 

re: Help!!! with 99385 and 96372

Any E/M service billed with 96372 will require a 25 modifier. We bill 96372 quite alot and do not have problems getting the E/M's paid. You may have to contact the insurance.



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