I have a claim that was billed 99213-25 and G0442 Annual alcohol misuse screening. The E/M were billed for different diagnosis codes than the G0442. It is my opinion that G0442 should be paid since the modifier 25 was billed on the E/M. Per NCCI edits a modifier is allowed. Someone else disagrees with me. This person states to override NCCI Edits that the modifier 25 has to be billed on both codes. I do not agree. Can someone help me either verify I am correct or explain to me why I am not. I cannot find any information stating the modifier 25 has to be billed on both codes to override the NCCI edit and I have not ever billed modifier -25 on anything but the E/M code.
I appreciate the help on this!
E/M Visit with CMS Preventative Screening
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