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UBH is denying a claim we sent with a 96136 and 96137, citing they need add on codes. After speaking with a representative, she hinted that I need a modifier. Has anyone else had this issue? What modifier would be appropriate?
NMills
It maybe a modifier defining the type of medical professional treating the patient. Check out AF modifier is speciality neurology or psych MD DO or PA,
LCSW is AJ modifier, Clinical psychologist is AH modifier, NP modifier is SA and or LPC is modifier HO. These are found in HCPCS manual too. If it is phone call 93 modifier and if telehealth 95 modifier add minutes too documentation. Physicians, psychologists, and qualified healthcare professionals use CPT code 96136 to bill the first 30 minutes of test administration. Code 96137 applies to each additional 30-minute increment.
I hope this data helps you
Lady T