Katie_Ellis
Contributor
Hello,
I am fairly new to orthopedic coding and our docs do a lot of injections! I am struggling with when it is okay to bill an office visit with the 25 modifier. The guidelines that I was told to go by was that we always bill a new patient (99202-99204) with the 25 when an injection is performed and with established patients, we only do if there is a separate complaint/issue that is addressed. I have researched this and I have found some information saying that as long as the patient is not making the appointment strictly for the injection, then there are instances where you can bill the OV with the 25. Does anyone know what are some things that would need to be dictated in order to do this? If the patient comes in and the doc goes over the diagnosis and other options before they settle on doing the injection, does this warrant the OV? Thanks in advance.
I am fairly new to orthopedic coding and our docs do a lot of injections! I am struggling with when it is okay to bill an office visit with the 25 modifier. The guidelines that I was told to go by was that we always bill a new patient (99202-99204) with the 25 when an injection is performed and with established patients, we only do if there is a separate complaint/issue that is addressed. I have researched this and I have found some information saying that as long as the patient is not making the appointment strictly for the injection, then there are instances where you can bill the OV with the 25. Does anyone know what are some things that would need to be dictated in order to do this? If the patient comes in and the doc goes over the diagnosis and other options before they settle on doing the injection, does this warrant the OV? Thanks in advance.