Wiki code 99393

[juanita.babuca@uahealth.com]

hi
I need you help
Provider billing CPTs
99393
90471 - SL
90649 - SL
Does 99393 requires a 25 modifier?

thank you so much for your help

 

[andersont]

90471 doesn't need a modifier. I only put mod. 25 on the CPT if it's a commercial insurance. SL only is attached if the insurance is a state (DSHS). If the insurance is state, no adminstration is billed.

 

[rthames052006]

hi
I need you help
Provider billing CPTs
99393
90471 - SL
90649 - SL
Does 99393 requires a 25 modifier?

thank you so much for your help

Yes- 99393 requires modifier 25. This was effective Jan 2013. Most carriers had a blurb in their newsletters, some didn't start Jan but if you check CCI edits you'll see it there as well.