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Podiatry Coding & Billing Alert

Modifier:

Modifier 25 Proves Handy in These 2 Scenarios

Published on Sat Sep 11, 2010

HEM and OBTW are important acronyms you should remember. What do they mean?If you're dreading an unwanted visit from your auditor or the Office of Inspector General (OIG), you should begin to pay close attention to your methods of appending modifier 25. Test yourself on the proper application of this modifier with the following scenarios.Stick to the Basics of History, Exam and Medical Decision-MakingScenario 1: A podiatrist examines an established patient suffering from pain in her left ankle. The podiatrist performs a full evaluation of the patient, including history, exam and medical decision-making, and decides to take an X-ray.Consequently, she determines that the patient suffers from Achilles tendonitis (726.71). Based on her workup, the podiatrist decides to give the patient a steroid injection.Solution: You should report 9923x-25 in addition to 20550 (Injection[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar "fascia"]) or 20551 (...single tendon origin/ insertion). A key to [...]
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