# Help!!



## wnarvaez72 (Jul 14, 2016)

We used to get reimbursed for example: E/M 99213 with modifier 25 , J1100 and 96372. Now we only get reimbursed for the J1100 with 96372 minus the E/M code.
 Do we not need a modifier 25 for injections?


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## kmgauthier (Jul 14, 2016)

There is now a CCI edit for 99213 and 96372. If the services are in fact separately identifiable, I append a 59 modifier to the injection in addition to the 25 on the visit.


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## Joan Schweikert (Jul 14, 2016)

I have my Dr.s includ comobities in their notes. the dictation for the office needs more then the injection area or sight


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## wnarvaez72 (Jul 20, 2016)

kmgauthier said:


> There is now a CCI edit for 99213 and 96372. If the services are in fact separately identifiable, I append a 59 modifier to the injection in addition to the 25 on the visit.





Ok.. Thanks
So 96372 needs a modifier 59?


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## CodingKing (Jul 21, 2016)

wnarvaez72 said:


> Ok.. Thanks
> So 96372 needs a modifier 59?



Correct. Well as long as the purpose of the visit wasn't the injection.


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## outen002@gmail.com (Jul 21, 2016)

*E/m codes*

I Would like to know....... What E/M Codes should be used when a family practitioner goes to a inpatient psych residential eating disorder facility to provide Medical Care initial and subsequent visits.


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## michelleaapc2012 (Jul 21, 2016)

wnarvaez72 said:


> We used to get reimbursed for example: E/M 99213 with modifier 25 , J1100 and 96372. Now we only get reimbursed for the J1100 with 96372 minus the E/M code.
> Do we not need a modifier 25 for injections?



What insurance company are you having the issue with?


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## wnarvaez72 (Jul 21, 2016)

michelleaapc2012 said:


> What insurance company are you having the issue with?





Just about all of them...


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## Herbie Lorona (Jul 27, 2016)

I don't believe you need a 59 modifier on the 96372 only the 25 on the E&M code.


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## boogie9483 (Jul 28, 2016)

The person who said to use mod 59 is incorrect. 



You should call the payors and ask them why they are denying. Possibly appeal with medical documentation.


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