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Question:
I’m being told I need a modifier if I bill 79005 and 78014 together. Do you know which modifier and why?
Answer:
Because it is not usual to do a diagnostic scan and then therapy on the same day, you have to use a modifier that tells the insurance that this was an unusual circumstance and that you really did both. You would use either 59 or XU for this on one of the codes.
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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