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Anesthesia Coding Alert

Pain Management:

Adding Modifiers 25, 50, or 59? Check for Correct Circumstances

Published on Tue Aug 02, 2011

Knowing which modifier to append -- and when -- can help your injection claims. If you code for pain management providers, chances are you report procedures such as facet, paravertebral facet, epidural, and nerve injections. Because providers might perform many of these injections in conjunction with another service, you might report more than the injection on your claim. Brush up on how --and when -- to append three common modifiers and ensure accurate injection pay. Add Modifier 25 to Associated E/M Visit When your pain management provider administers an unrelated injection during a standard E/M visit, remember modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). Example: A patient visits your office for a follow-up for his chronic low back pain. During the evaluation, he also complains of left elbow pain, which the physician determines to be recurrent lateral [...]
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