Billing both 99211 and 36415 for same date of service

Example.

Patient comes in for protime and during the visit, there is face-to-face with the patient because of abnormal readings. We would normally bill for a 99211 and the lab test.

On this same day, the patient decides to also go to lab and have other labs drawn that are not associated with the protime visit. We would normally bill the 36415.

Because both are done on the same day, is it appropriate to bill a 99211 with modifier 25 AND the 36415 for the lab draw that was done by the lab tech in our lab? Different diagnosis than what is on the protime.

re: Billing both 99211 and 36415 for same date of service

URGENT..... why isn't anyone responding to my question? Does anyone know the answer to this issue? Thank you

re: Billing both 99211 and 36415 for same date of service

If the patient goes to the lab, why are you billing 36415? Is the lab drawing the blood?

I assume the payer is denying it because you are billing the pro time, and they are assuming that the lab draw was for the pro time, and they correctly know that you did a fingerstick for the pro time.

If you did draw blood (you, not the lab) for an additional test, you will need to appeal it and show that it was distinct from the pro time.

re: Billing both 99211 and 36415 for same date of service

Yes, our "in-house" lab drew the blood for the labs not associated with the ProTime. I was instructed by someone that because they are not related, that we should append a modifier 25 to the 99211 charge for the face-to-face visit for the ProTime. Is this correct?

re: Billing both 99211 and 36415 for same date of service

You should not need the -25. The diagnoses attached to each should be different; be sure the lab is not using the same ICD-9 as the 99211.