Forum - Questions & Answers

Jul 30th, 2015 - mcint119

Has anyone billed 99213-25, 99396-25 with 90471 with BCBS of GA and gotten paid for all 3 codes?

We have been billing 99213-25, 99396 and 90471 and BCBS is denying 99396 bundling it with 90471. Per NCCI edits, 99396 needs a modifier. I have never billed both E&M codes with modifier 25.

Anyone had any experience with this?

Jul 31st, 2015 - rphelps 615  1 

re: Has anyone billed 99213-25, 99396-25 with 90471 with BCBS of GA and gotten paid for all 3 codes?

Is 99396 the correct age for the patient. Maybe you don't need a 25 on 99396 just 99213. I really don't know but it's a possibility.



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