Wiki Billing 99401 along with an E/M Code

[Biller2023]

Everytime we bill 99401 with an E/M Code like 99213, 99214 etc, 99401 gets denied stating mutually exclusive procedure cannot be done on the same setting. We are billing E/M with a 25 modifier when we add 99401 but still the claims get denied. How should we bill 99401 along with an E/M Code? Quick response will be appreciated. Thanks.

 

[Cbaxter001]

Howdy! The modifer 25 needs to go on the 99401, not the E/M code.

 

[Biller2023]

Appreciate the quick response. I know that Medicare does not pay for 99401, what are the other insurances that don't pay for 99401,99402, etc...

 

[Biller2023]

I've billed 99401 with 25 modifier but still insurance pays for the E/M and denies 99401 stating CO231 (mutually exclusive procedure). Let me know how to fix this please.