A modifier is probably not the reason for denial. It is necessary to review the payment policies of each payer to determine whether screening eye examinations are paid in conjunction with preventive medicine services. Policies vary, with some payers allowing instrument-based ocular screening (99174, 99177) as a separately paid service twice per year for children aged 0 to 12 months and once per year for children 1 to 5 years old in addition to well-child visits. Other plans bundle the screening eye examination and pay only the pediatric preventive medicine evaluation and management (E/M) service (99381–99385, 99391–99395) when provided on the same date. Still other plans will pay for screening eye examinations only for patients between the ages of 3 and 5 years, or pay only when nonautomated screening is performed (99173). Practice or billing managers should develop a process for maintaining...

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