# 99177 and office visit



## Dharti87 (Mar 13, 2018)

Cpt 99177 comes back denied when submitting with an office visit, even when submitted with a 59 mod. Any suggestions on how to get this code paid?


----------



## mitchellde (Mar 13, 2018)

Assuming the documentation supports it, have you attached the 25modifier to the office level?


----------



## Dharti87 (Apr 13, 2018)

yes and filled appeals


----------



## clayjagod1 (Apr 13, 2018)

CPT manual states that it is not to be billed with an office visit (I assume the office visit you're referring to is 92002-92014). The P2P Edits on CMS' website states it is bundled with the exam also. Commercial payers may have age restrictions on the code as well. It would be helpful to know which carrier you are billing and what are the adjustment codes you are receiving on the remit.


----------



## Dharti87 (Apr 26, 2018)

clayjagod1 said:


> CPT manual states that it is not to be billed with an office visit (I assume the office visit you're referring to is 92002-92014). The P2P Edits on CMS' website states it is bundled with the exam also. Commercial payers may have age restrictions on the code as well. It would be helpful to know which carrier you are billing and what are the adjustment codes you are receiving on the remit.




We bill it out not with office visits I'm sorry I meant with well visits 99391-9939*, and It mostly BCBS that denies it with codes CO4, N519  (if submitted with imms and such we have to add modifier 59 to distinct it)


----------



## Cynthia Hughes (Apr 26, 2018)

*99177*



Dharti87 said:


> We bill it out not with office visits I'm sorry I meant with well visits 99391-9939*, and It mostly BCBS that denies it with codes CO4, N519  (if submitted with imms and such we have to add modifier 59 to distinct it)



Check the specific payers policy for preventive services. Some allow separate payment for automated vision screening for children up to 5-years-old and some do not. The reimbursement policies are often posted on the payer's site.

Cindy


----------



## steinbrc (Mar 17, 2022)

How old is the patient?  I found on the GoCheck Kids site that adding a modifier 33 for ages 3-5 only and to add modifier 59 with a wellness visit, both modifiers if between 3-5 years old.  Our office just started using this so in the early stages still...


----------

