Medical Billing Coding - Billing for J1885 with E/M 99213, cpt, codes
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Thread Topic: Billing for J1885 with E/M 99213
Topic Originator: Monica
Post Date June 26, 2012 @ 3:56 PM
Billing for J1885 with E/M 99213

June 26, 2012 @ 3:56 PM Reply  |  Email Friend   |  |Print  |  Top


Can anyone help me with the correct modifier to use when billing j1885, I used 25-for 99213 and 59 for j1885, and I received a resp from Blue Cross that this is not the correct modifier to use.

Thank you.

June 27, 2012 @ 9:12 AM Reply  |  Email Friend   |  |Print  |  Top

99213 -25 -59
j1885 -50 -99

July 3, 2012 @ 1:28 PM Reply  |  Email Friend   |  |Print  |  Top

Thank you.

November 1, 2012 @ 9:42 AM Reply  |  Email Friend   |  |Print  |  Top

You would put the 59 mod on the inj 96372 and 25 on OV 99213

November 9, 2012 @ 12:27 PM Reply  |  Email Friend   |  |Print  |  Top

I guess I am a little concerned about adding a modifier 59 or 50 on J1885 as modifier 59 is used on procedures and modifier 50 is bilateral.   We bill an office visit and modify the office visit with a 25 and do not modify the injection or the administration fee.  When we did modify the injuection we would get the response incorrect modification and once the modifier was removed from the injection and the administration fee the claim paid as did the injection and the administration fee.  Correct me if I am missing something here.

November 9, 2012 @ 6:28 PM Reply  |  Email Friend   |  |Print  |  Top

We use modifier 25 on all office visits and modifier 50 and 59 on all non office visits.  We use anything we can because our policy is to get everything paid, no matter what.  Thats why we do billing and we get every claim paid.  No matter what.  It works for us,

July 7, 2015 @ 7:40 AM Reply  |  Email Friend   |  |Print  |  Top

Byron- if you're just slapping on modifiers to get claims paid that's illegal. You should make sure it's coded correctly and cover all of your bases before throwing out modifiers.

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