# psych visit/E/M visit



## ktress (May 19, 2009)

Hi, We have an issue where a patient came in for a 99211, then they had a Psych visit 90806, Insurance is telling us that it is bundled. These were performed by 2 seperate physcians in our practice. Should we append a modifier? Would a 59 help get this paid?


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## neha.bhatnagar (May 20, 2009)

Did you used a 25 modifier with 99211? If not resubmit with 25 modifier.


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## tfreeland (Jun 4, 2009)

If a physician saw the patient, a 99212 instead of 99211 would be appropriate if you have the documentation (which you usually do).  We only use 99211 for a nurse visit.  Use mod-25 on E/M code if you do an injection admin at the same visit.  

Terri Freeland, CMM,CFPC


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## FTessaBartels (Jun 9, 2009)

*99211 CAN be used by physician*

99211 *can* be coded (if appropriate to the documentation) for a physician visit. 

F Tessa Bartels, CPC, CEMC


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## RNCPC0709 (Jun 10, 2009)

99211 is NOT just a "nursing" code and is appropriately billed for services rendered by a physician.  Aside from that, you should append modifier 25 to the 99211.  The payer's system is probably reading the TIN# for both services and denying as it thinks both were by the same provider.


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## mitchellde (Jun 10, 2009)

I f these are two separate physicians, in 2 different specialties then you should be using 2 separate 1500s and there is no need for a modifier.  If both physicians are in the same specialty then you cannot bill both encounters on the same day.  Can you give more of the scenario for analysis?


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