Forum - Questions & Answers
CPT® question
Can I bill 99396/25 with 99212/25 together.
re: CPT® question
you only need the modifier on the additional office visit 99212
re: CPT® question
Also the problem for the 99212 must be significant. It can be a chronic problem that is worsening or an acute problem that either one need to be acted upon by the provider. The provider needs to at least order meds or tests.
re: CPT® question
So to lay it out:
You would bill the 99396/25 and point it to the well visit.
On the second line (same date) you would bill 99212 and point it to the diagnosis that the doctor came across during the well visit, to justify billing an office visit on the same day of a preventative visit.
Does that make sense?
re: CPT® question
You would actually bill the 99396 then the 99212-25 and yes you are correct to point the diagnoses. Keep in mind though that to bill each visit you must have enough documentation to meet the criteria of the two separate visits. You cannot count information documented for the wellness visit to the problem visit also. It has to be a significant, separately identifiable problem visit.
re: CPT® question
no that is incorrect is should be billed like this
99396 DX for well visit
99212/25 - DX for sick visit
always put the modifier on the additional office visit and not the well visit..