jotten
New
I am having some difficulty with on of our Medicaid payers, they sent us a provider update stating that we can bill a preventative EPSDT visit with a level 1 or level 2 office visit if diagnosis warranted it. My understanding is that when a EPSDT visit is billed we place the modifers EP & 25 on that CPT code (ie: 99392) when we also preform other procedures (vaccines vision etc) IF the provider also discovers another problem (rhinitis) and does a lower level office visit (per the provider update) we can also bill an E/M visit with a modifier 25.
Both the EPSDT visit and the E/M are being denied as incidental to the vaccine admin. code. My question is can I place modifier 25 on BOTH EPSDT visit AND E/M code or only on E/M and no modifier on EPSDT code?
Example: 99392 EP 25 V20.2 OR 99392
99211 25 460 99211 25
90744 V20.2 90744
90648 V20.2 90648
90471 V20.2 90471
90472 V20.2 90472
All of that is a bit confusing I apologize, but any help given would be GREATLY appreciated!!
Both the EPSDT visit and the E/M are being denied as incidental to the vaccine admin. code. My question is can I place modifier 25 on BOTH EPSDT visit AND E/M code or only on E/M and no modifier on EPSDT code?
Example: 99392 EP 25 V20.2 OR 99392
99211 25 460 99211 25
90744 V20.2 90744
90648 V20.2 90648
90471 V20.2 90471
90472 V20.2 90472
All of that is a bit confusing I apologize, but any help given would be GREATLY appreciated!!