Preventive w/ E/M, injections

I could use some assistance on how I should have coded the following scenario:
A commercial insurance patient was seen for her Annual Physical (99396). While in the office, she complained of flu-like symptoms and a rash. She received a rocephin injection (96372-injection; J0696-rocephin). A U/A was done as part of the physical. I coded the claim as follows:
99396-25 (linked to V70.0 only)
99213 (linked to 488.19-flu; 782.1-rash; 786.2-cough)
J0696 (linked to 488.19; 786.2)
96372 (linked to 488.19; 786.2)
81003-QW (linked to V70.0 only)

I stressed over coding the claim before I sent it because I knew if I appended the E/M visit code (99213) with the -25 modifier, the Preventive payment would be bundled with the rocephin and injection. So, I appended the -25 modifier to the Preventive code. I got paid for the Preventive exam, the rocephin, the injection and the U/A. But insurance denied the E/M visit stating on the ERA "CO-234-This procedure not paid separately" and N19 "Procedure code incidental to primary code". Also, the insurance left the patient with a co-pay; not on the E/M code (since it was denied), but on the rocephin payment.

Is/was there a way to code the claim to get paid for the Preventive, E/M and the injections? I researched and could find nothing (however, I am still fairly new at all of this) stating that modifier -25 could be used twice on a claim. Was there another modifier I could have used? Or should I be glad I got paid for the higher reimbursing Preventive and the injections and cut the loss of the E/M? Any feedback would be greatly appreciated! Thanks in advance!

re: Preventive w/ E/M, injections

[I could use some assistance on how I should have coded the following scenario:
A commercial insurance patient was seen for her Annual Physical (99396). While in the office, she complained of flu-like symptoms and a rash. She received a rocephin injection (96372-injection; J0696-rocephin). A U/A was done as part of the physical. I coded the claim as follows:
99396-25 (linked to V70.0 only)
99213 (linked to 488.19-flu; 782.1-rash; 786.2-cough)
J0696 (linked to 488.19; 786.2)
96372 (linked to 488.19; 786.2)
81003-QW (linked to V70.0 only)

I stressed over coding the claim before I sent it because I knew if I appended the E/M visit code (99213) with the -25 modifier, the Preventive payment would be bundled with the rocephin and injection. So, I appended the -25 modifier to the Preventive code. I got paid for the Preventive exam, the rocephin, the injection and the U/A. But insurance denied the E/M visit stating on the ERA "CO-234-This procedure not paid separately" and N19 "Procedure code incidental to primary code". Also, the insurance left the patient with a co-pay; not on the E/M code (since it was denied), but on the rocephin payment.

Is/was there a way to code the claim to get paid for the Preventive, E/M and the injections? I researched and could find nothing (however, I am still fairly new at all of this) stating that modifier -25 could be used twice on a claim. Was there another modifier I could have used? Or should I be glad I got paid for the higher reimbursing Preventive and the injections and cut the loss of the E/M? Any feedback would be greatly appreciated! Thanks in advance!]

I would put the 25 on the 99213.

re: Preventive w/ E/M, injections

This is how I get paid for all these done together:
99213-25
99396
J0696/59
96372/59
81003/QW

re: Preventive w/ E/M, injections

Thank you!