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Old 06-03-2008, 11:46 AM
heatherwinters heatherwinters is offline
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Default 99395 with modifier 25

If you bill a preventative medicine code (99395) and you did an immunization Tdap and administration, do you bill a modifier 25 on the 99395. I thought that modifier 25 was only for use on 99201-99357. Thanks
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Old 06-03-2008, 01:46 PM
Lisa Bledsoe Lisa Bledsoe is offline
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Although one would not expect to need a modifier -25 on a preventive code, it seems that more payers are requiring it or the ancillary services won't get paid - like the immunizations. As coders, we are taught not to slap a modifier on everything, but payers won't pay if we don't. Quite a conundrum.
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Old 06-03-2008, 04:54 PM
LOVE2CODE LOVE2CODE is offline
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Quote:
Originally Posted by heatherwinters View Post
If you bill a preventative medicine code (99395) and you did an immunization Tdap and administration, do you bill a modifier 25 on the 99395. I thought that modifier 25 was only for use on 99201-99357. Thanks

The answer is no....You would use modifier 25 on 99201-99357 if use on the same visit as the preventive code....


YTH, CPC
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Old 06-04-2008, 08:12 AM
EARREYGUE EARREYGUE is offline
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I would not use it, unless the claim comes back requesting a modifier, we were using mod.25 for a while on well checks with vaccines and were told we are over using mod.25 by our compliance dept.
E.A. C.P.C.
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Old 04-25-2010, 02:05 PM
LOVETAMBRA LOVETAMBRA is offline
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Default Modifier 25

I have a patient who came in for a well woman and IUD removal, should I use the 25 modifier on the 99395?
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