# 99213, 97032, & 97035



## LDWICK24 (Dec 6, 2016)

What modifiers should be applied to these CPT codes on a claim? Only the modifier 25 has been applied to the 99213 and this CPT paid, but the 97032 & 97035 have denied with the following explanation: CO4 "The procedure code is inconsistent with the modifier use OR a required modifier is missing.  
How should this be billed?


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## CodingKing (Dec 6, 2016)

Medicare, Medicaid, Commercial? What specialty and payer? Could be mod 59 to show they are significant and separate from the E&M. Some payers may want a modifier to show if the modalities are under a PT, OT plan of care.

for instance

[h=2]Therapy code modifiers[/h]

*GN*: Indicates services delivered under an outpatient *speech-language* pathology plan of care
*GO*: Indicates services delivered under an outpatient *occupational* therapy plan of care
*GP*: Indicates services delivered under an outpatient *physical* therapy plan of care


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## LDWICK24 (Dec 21, 2016)

codingking

this is for Medicare and the setting is pain clinic, performed by MD


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