Thank you sbicknell, that is what I thought. Here is the issue we are having.
A 6 month old child comes in for a well care visit, immunizations and mom is concerned about the childs vision so we perform a 95930 Visual Evoked Potential Screening on the baby and it was found to be abnormal so we referred the parent to an ophthalmologist. The original billing on this was 99391 DX V20.2, 379.99, 382.00, 95930 DX 379.99, A4556, A6411, A4558, 90648, 90723, 90669, 90465, 90466. The original claim did not include a modifier.
Aetna bundled the 99391 and 95930 and the told us that it would be paid if the 59 modifier was added to 99391. I knew that was not correct so I corrected the claim to have the 59 modifier on the 95930 procedure and it stilled denied.
I do have other claims that the 25 modifier was added to the 99391, but Aetna bundled that also. I do not understand they were reimbursing for both up until February of this year.