Medical billing quiz - CPT 99213 AND 94760, modifier 66 using wiht outpatient surgery

FAQ about Medical Billing


Can you code 99213 and 94760 together

Ans :  No.

Note : CPT 94760 is a non-covered/inclusive procedure if it is performed along with 99201-99205 or 99211-99215 and 99241-99245 on the same date of service. Please write off CPT 94760 in such cases. Please note that the CPT 94760 should be paid if the same is performed alone on a particular DOS.

Can CPT 99214 be billed to Medicare with CPT 94760

Ans : No.

Note: Pulse oximetry (CPT 94760) is not allowed with any other services performed on the same day. The National Correct Coding Initiative (NCCI) edits bundle the following tests when the physician performs them on the same day. Typically, to get paid for billing the codes separately, you have to use modifier -59 (Distinct procedural service). And, you can never bill pulse oximetry (such as 94760) with another payable service.


Can CPT modifier 66 be used for an outpatient surgery

Ans :  No.

Note : Surgical team - The modifier should be used by each participating surgeon to report his services. When team surgery is medically necessary, the carrier will determine the appropriate allowances(s) "by report." You can use modifier 73 and 74 for ASC hospital outpatient only.

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