modifer -25

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    Wiki Correct usage of modifier 25

    Hello Everyone! My coworkers and I are trying to figure out the correct usage of modifier 25. We recently had a patient come to the hospital with periumbilical pain for an umbilical hernia that they have had for several years. Our doctor did a consult with a review of systems and physical...
  2. E

    Wiki Child Well Visit with Sick Visit

    We have sent several claims to the insurance since they do not pay us for the child well visit along with the sick visit which they do. We have used the modifier 25 alone, then only AM and finally 25 and AM together in CPT 99391 but the insurance still continues to deny preventive child care...
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    Wiki Modifier 25 , E/M with minor procedure

    I thought I would get people's thoughts on adding an E/M to a minor procedure (cysto). I keep going back and forth on what would be correct. Pt comes in for scheduled Cysto due to BPH luts, they are able to determine severity of enlargement and after the procedure they discuss possible options...
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    Wiki Initial Prescription of OCPs following a IUD removal

    Our provider sees a patient for an IUD removal. On the same day, provider started oral contraceptives. Is it appropriate to bill a separate E/M code for this reason? Appending modifier -25 to this E/M code. Appreciate the reponse!
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