Forum - Questions & Answers
Modifer Help!!! Please!!!!
What modifer do I use when billing 94640 & 94060 on the same claim? Thank You! Lynn
re: Modifer Help!!! Please!!!!
These two codes are bundled together and are not separately reportable unless separate and distinct procedures were performed .
re: Modifer Help!!! Please!!!!
If you bill them use a 59 modifier on one of them.
re: Modifer Help!!! Please!!!!
Try putting the 59 modifier on the 94640. Also, if an evaluation and management is done, you will need a 25 modifier on the visit, other wise you might not get paid for the visit.
re: Modifer Help!!! Please!!!!
You can't just unbundle them by appending a 59 modifier without knowing whether it is appropriate to do so and it is irresponsible for someone to suggest a modifier without knowing if what your physician is doing is separate and distinct.
Yes, a 59 modifier will get them paid, but is it appropriate to do so in your case and are you fraudulently unbundling them?