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newhall94

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I find myself on the other side of the coin. I am a coder/biller for a Gastroenterology practice so I don't know much about the pediatric side of things. I have three children, two had their well child check ups this year with all the "standard" things they do. Hearing, eye, blood, urine, etc...however when my last child went, he had the same things done and now my insurance says that the preventative eye screening is not a covered service. My question is, why if the same office did the same things, billed the same way and my insurance has not changed, why isn't his screening covered. Is there something the doctor's office is missing? Does it need a modifier? It's not a huge deal but it's the principle here...
 
The major insurance companies bundle this into the exam. If you put the 59 modifier on it they usually pay. Maybe your doctor's office forgot to append the modifier.

Cathy
 
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