Wiki BILLING EPSDT

[mtfbiller]

Anybody billling in NJ? When billing EPSDT with modifier EP and the patient has any other symptons adding OV and modifier 25, Horizon NJ Health and United denied the annual cpt code saying I'm using improper modifier; but when I billed without OV the paid the annual code with modifier EP. But United Healthcare if I billing vaccines they denied saying I missed modifier, but the claim has modifier EP appended to the annual code.

 

[rthomas@impcna.com]

I'm not in NJ but in MS when we bill an EPSDT visit (well visit) and regular office visit we have to put EP & 25 on the well e/m and 25 on the regular office visit. When we are doing well visit and vaccines we have to use EP & 25 on the well e/m. We have 3 different medicaid payers with United being on of them.

 

[mtfbiller]

Thank you very much