Does CPT 96375 need a modifier?
CPT codes 96374 and +96375 are considered integral to the intubation procedure, therefore you cannot separately code and bill them. However, if the IV pushes are separate and distinct from the intubation, assigning the IV push codes with modifier -59 (distinct procedural service) is appropriate.
What is the primary CPT code for 96375?
CPT® 96375, Under Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration)
Which CPT code does modifier 59 go on?
If the circumstance calls for a Level 3 established patient visit (CPT code 99213) to be billed with psychological testing (such as CPT code 96101), modifier 59 would be appended to the testing code.
What replaced modifier 59?
Medicare recently announced they’ve established four new modifiers – XE, XS, XP, and XU – that may be used in lieu of modifier 59. The codes are more specific and become effective January 1, 2015.
Is CPT 96375 an add-on code?
Add-on code +96375 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure) may be reported with 96365, 96374, 96409, or 96413 to identify an IV push of a new drug when …
What does modifier 59 indicate?
Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.
Does modifier 59 affect payment?
Like modifier 51, modifier 59 also has payment implications. Modifier 51 impacts the payment amount, and modifier 59 affects whether the service will be paid at all. Modifier 59 is typically used to override National Correct Coding Initiative (NCCI) Edits.