I have been trying to research this and I am getting mixed results. Example: pt presents to ortho for post injury impact testing. Provider documentation supports the E/M visit along with the impact testing. We have been billing the E/M along with the 96120 for the impact testing. Some carriers are accepting these with a 25 modifier on the E/M with no issue, but the majority are denying these stating that they are bundled with the E/M. I have conflicting information on whether the 25 should be used, information stating that the 96120 needs a modifier, and another source stated that we should be using a psych dx in addition to the concussion dx. Can anyone give me any guidance on this?
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