DecisionHealth, DecisionHealth - 2016 Issue 8 (August)

Use a modifier to overcome bundled codes involving advance care planning

Question: I have a provider who is billing for CPT code 99497, which is advance care planning (ACP), and I’m receiving denials on some claims — but not others. For example, I get denied every time I bill 99497 with hospital code 99222. Yet my claims with 99232 go through successfully. Can you help?

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