DB 4 - modifier to indicate that it is a separate and...

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Lorrraine Huff Unit 4 DB September 20, 2009 Bundling is when an insurance carrier combines two or more CPT codes, substituting one overarching code, often ignoring modifiers along the way. Bundling can cut down on your receivables because by bundling the codes together they are only allowing the fee schedule allowance for the one code that they feel is appropriate. For example, if you are billing for an E&M code for a patient who comes in with high blood pressure but the patient is also complaining of knee pain and you end up doing an aspiration of the knee joint, then you need to make sure you use the correct modifiers to indicate what you are doing. For example, you want to bill the E&M code, say it is a 99213, with a 25
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Unformatted text preview: modifier to indicate that it is a separate and distinct service provided during the same visit. Then you would bill for the aspiration of the knee joint with the appropriate code using a 59 modifier to indicate a distinct procedural service. Services are sometimes bundled when spinal manipulation codes are used in conjunction with codes for massage or manual therapy services such as soft-tissue mobilization on the same date of service because some insurers believe there is an overlap in the services. References Redmond, M. (2007, October 5). Bundling Of CPT Codes . Retrieved September 19, 2009, from Solutions Medical Billing Blog: http://solutionsmedicalbilling.blogspot.com/2007/10/bundling-of-cpt-codes.html...
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