Wiki 99214, 99406, 90472, 96372

[mcurtis739]

Hi All

Can someone please explain to me how to bill for the following on the same day.

99214
99406
90472
96372

When I append the 25 modifier, I get the following:

The Diagnosis Code(s) submitted with the Procedure Code (99406) does not meet or may not fully support Medical Necessity.
Code 99406 is a component of code 90472 but a modifier is allowed on 99406.
The Procedure Code (90472) is defined as an add-on code.
The Procedure Code (90472) is invalid or requires a parent that is not on the claim.

The patient is in his 40s so I'm confused what the last line means.

Thank you again!

 

[Pathos]

Hello,

*For 99406, you would need to link it with a Nicotine Dependence ICD-10 code in order to show medical necessity (which should naturally be documented properly).

*90472 is an add on code, you will need a parent code (or a primary code) in the same coding family as 90472. For example, 90471 shows a single vaccine, while 90472 shows an additional vaccine being administered on the same day.