Wiki Should we use -25, -59 or ????

tvaughn

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:confused: I work for a pain management group and we've had the question of what modifier should be used when these codes are being billed together for same DOS........

99213 E/M level
96103 Psych test
36415 Venipuncture
 
Without having the notes in front of me to be sure I would suggest the below. However, the documentation for the E/M needs to support a completely separate and distinct reason for the E/M in order to bill the 96103 and 99213 together. If the patient is coming in specifically for 96103 and 36415, and the documentation does not support a separate reason for the evaluation I wouldn't risk billing the E/M.

99213/25
96103/59
36415
 
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