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Can I bill these two codes together?

The question the payer answers with a denial. This is the list billers actually search: which pairs need a modifier, which are mutually exclusive, and which you simply cannot bill on the same day. Type a code to filter.

0 pairs listed. Filter as you type.

Read the verdict first

Three answers, and what they mean

Yes

Bill both

Separately payable as filed, or an add-on that rides its primary. No modifier gymnastics required.

With a modifier

Yes, if distinct

Billable only when the services were genuinely separate, and you say so with modifier 25 or 59 (or an X modifier). Documentation has to back it.

No

Do not bill both

Mutually exclusive, one code includes the other, or you are trying to bill two of the same thing. No modifier rescues it.

Office visit plus a procedure (modifier 25)

Modifier 25Office visit (99213/99214) + 20610 joint injection

Billable when the visit was a separately identifiable evaluation beyond the routine work the injection includes. Append modifier 25 to the E/M. If the note reads like the setup for the injection, it bundles with CO-97. Full rules in the modifier 25 explainer.

Modifier 25Office visit (99214) + 96372 therapeutic injection

Yes, with modifier 25 on the E/M when a separate problem was evaluated. Bill the drug separately with its J-code. Routine injection-only visits do not support a separate E/M.

Modifier 25Preventive visit (99396/99397) + problem E/M (99213)

Yes, when a significant problem is addressed during the physical. Bill the preventive code and the problem E/M with modifier 25. Both diagnoses should be documented distinctly.

Modifier 25Medicare AWV (G0438/G0439) + problem E/M (99214)

Yes. Bill the annual wellness visit and a medically necessary problem E/M with modifier 25 on the E/M. This is one of the most common legitimate uses of modifier 25 in primary care.

Modifier 25Nail/callus care (11720/11055) + office visit

Only if a separate problem beyond the routine foot care was evaluated, with modifier 25 on the E/M. A visit for the foot care alone does not support a separate office visit. See the podiatry billing guide.

Two E/M or two of the same thing

No99213 + 99214 on the same visit

No. These are two levels of the same office-visit family. One provider, one encounter, one level, chosen by medical decision making or total time. You do not stack E/M levels.

No90834 + 90837 for one session

No. Pick one psychotherapy code by the documented time: 90832 is 16 to 37 minutes, 90834 is 38 to 52, 90837 is 53 or more. See the mental health billing guide.

Add-on codes (bill with the primary)

Yes90837 + 90785 interactive complexity

Yes. 90785 is an add-on reported with the psychotherapy code, never alone, and only when a real communication barrier is present (a young child, an interpreter, a court-involved third party). Routine use is an audit flag.

Yes17000 + 17003 (multiple actinic keratoses)

Yes. 17000 is the first lesion, 17003 each additional lesion from the 2nd through the 14th. At 15 or more lesions, use 17004 alone, not 17000 plus fourteen units of 17003.

Yes99214 + G2211 visit complexity

Yes, and as of 2025 you can bill G2211 even when the E/M carries modifier 25 for a same-day wellness visit, vaccine, or Part B preventive service. Before 2025, that combination was blocked, which is why older guidance says otherwise.

Bundled by NCCI (modifier 59 territory)

Modifier 5997140 + 97530 (manual therapy + therapeutic activities)

97140 bundles into 97530 under NCCI. Billable together only when they were distinct services (a separate 15-minute block or a different region), with modifier 59 or XS on the column-two code. Otherwise the second denies with CO-97 or CO-236. See the therapy billing guide.

Modifier 5997140 + 98940/98941 (manual therapy + chiropractic CMT)

97140 on the same region as the manipulation is bundled and not separately payable. A different region can be billed with modifier 59 or XS, documented. For Medicare, 97140 is non-covered for a chiropractor regardless. See the chiropractic billing guide.

Modifier 5911102 + 11104 (two biopsies, different lesions)

Yes, when they are genuinely separate lesions by different techniques, with modifier 59 or XS on the second. Note the biopsy add-on rule: one primary code per technique, add-ons for additional lesions of the same technique.

Mutually exclusive or overlapping

No92133 + 92134 (OCT optic nerve + retina)

No, not on the same day. These OCT codes are mutually exclusive with an NCCI indicator of 0, so no modifier unbundles them. Bill the one that drove the decision. See the optometry billing guide.

Payer-dependent97153 + 97155 (ABA, same clock time)

It depends on the payer. Some allow the BCBA's protocol modification (97155) to overlap the technician's treatment (97153); many deny concurrent billing of the same clock time as CO-97. Check the payer policy before billing both. See the ABA billing guide.

No99490 (CCM) + 99495 (TCM) in the same month

Do not double-count. Chronic care management and transitional care management have overlap rules, and the same minutes cannot count toward both in a calendar month. Billing both for the same period draws an overlap denial.

Split billing (both correct)

Yes66984-54 + 66984-55 (cataract co-management)

Yes, but by two different providers on the same surgery code. The surgeon bills 66984 with modifier 54 (surgical care), the co-managing optometrist bills 66984 with modifier 55 (postoperative care) for the days actually managed. A written transfer-of-care agreement is required.

Check any claim, not just the common ones

This list covers the questions billers ask most. The scrubber runs every claim against the full NCCI edits and modifier rules before it goes out, so the answer arrives before the denial does.

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