Forum - Questions & Answers

Dec 1st, 2016 - MALVAREZP 1 

Guidelines to bill for CPT® 97002

Recently I submitted a claim which included CPT® 97110 and 97002. As far as I know, these codes can be claimed together as long as CPT® 97002 has the modifier 59 attached to it. My claim was denied because the billed services are considered components of the same procedure even though they were unbundled with the modifier 59. The claim was for a Medicaid member. Are they right? I've never had a problem with other insurance carriers when claiming CPT® 97002. Where can I revise the coding guidelines to bill these two procedures together?

Thank you for any help you can provide me with.

Maria A.

Jan 2nd, 2018 - ChrisW   256  1 


In 2016 97110 was reimbursable with 97002 if an NCCI Modifier is appropriate and used, using the CCI edits found on Find-A-Code.

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