Podiatry Coding & Billing Alert

2 scenarios show you how to apply modifier 25 for separate procedures. When patients come in for an problem-focused visit and your podiatrist performs an unrelated minor procedure such as a toe nail trim, you're leaving deserved pay in the table if you don't report that procedure. Read on for advice on how to accurately capture these separate services on your claims. For instance: "Podiatrists can get paid for 11721 (Trimming of nondystrophic nails, 6 or more) and 99212 (Office or other outpatient visit) with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same say of the procedure or other service)," says Paul Fehring of Drs. Central Billing, LLC in Fairfield, OH, Dx codes are key: Make sure you have "separate and identifiable diagnosis codes," says Fehring." "Modifier 25 is a target for audits, so be sure to totally document the ICD-9 codes [...]