Pediatric Coding Alert
Choose One Vision Test to Report
Question: When we perform the Snellin test (99173) on our patients, often the doctor will see a problem and request performance of spot vision testing (99174) as well. Our insurer has started rejected claims with both codes on them as being bundled so I want to resubmit those claims with a modifier on the spot vision test code to show that separate procedures were performed. Is modifier 59 the appropriate modifier to use in this situation?
Answer: Unfortunately, a modifier won’t allow you to bill both codes together, because CPT® specifically says “Do not report 99174 in conjunction with 99173.” Because 99174 pays about $8.00 and 99173 pays just $3.00, report 99174 if you do both tests so you can recoup the higher payment.
Pediatric Coding Alert
- Diagnosis Coding:
3 Mythbusters Prove That 'E' and 'V' Codes Can Help Your Case
Don’t ignore these often-overlooked diagnosis codes. Submitting claims for your pediatric visits can get tricky [...] - Compliance:
3 Lessons You Can Learn From These Pediatric Practices' Medicaid Audits
Follow this advice to make sure you aren’t in the hot seat. The word “audit” [...] - ICD-10:
Determine Whether You'll Be Able to Code These Diagnoses Next Year
Test yourself with this quick quiz. ICD-10’s implementation is less than a year away, and [...] - Reader Question:
Avoid Billing Before Physician Joins Medicaid
Question: We have a new doctor in our practice and she has not been added to [...] - Reader Question:
Choose One Vision Test to Report
Question: When we perform the Snellin test (99173) on our patients, often the doctor will see [...] - Reader Question:
Ensure Incision to Report 10120
Question: Our pediatrician removed a pencil tip from a patient’s finger and circled 10120 (Incision and [...] - Reader Question:
Count the Time for Prolonged Services
Question: During a scheduled office visit of an established patient, our physician spent additional office time [...] - Reader Question:
Choose From Among Several Diabetes Education Options
Question: A pediatrician and physician assistant are educating some parents on diabetes, exercise, and nutrition at [...] - You Be the Coder:
Create Your MCHAT Policy
Question: If we perform a pediatric test such as the MCHAT, must we retain the completed [...]
