JennRT929
New
Hello! We are receiving denials for Advanced Care Planning CPT 99497 from Cahaba Medicare stating that modifier 25 is an invalid modifier. I am at a loss. We are billing this on the same day as a PFT test and they are bundled but per CCI edits a modifier is allowed. Since ACP is under the E/M section I would think that modifier 25 would be most appropriate.
We are also receiving the same "modifier is inappropriate" when 99497 is billed on the same day as a preventive. Our MAC doesn't require modifier 33 so again, I would think that for two E/M services on the same day modifier 25 would apply.
Is anyone else having trouble billing 99497-99498 with modifier 25?
Thanks in advance!
We are also receiving the same "modifier is inappropriate" when 99497 is billed on the same day as a preventive. Our MAC doesn't require modifier 33 so again, I would think that for two E/M services on the same day modifier 25 would apply.
Is anyone else having trouble billing 99497-99498 with modifier 25?
Thanks in advance!