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Wiki 25 Modifier

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amym

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Loganville, GA
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Is it ok to add a modifier if a patient comes in for a scheduled ETT, 93015, and sees the doctor after to go over the results? The test was normal but the doctor prescribes new meds based on the results of the test.

What about if it's just to clear patient for surgery (after the test)?
 
The 93015 (global status indicator XXX) is not considered a true minor procedure so if the provider does an E&M service after the test and based on what you are describing requires at least some level of Medical Decision due to the medication adjustment/management thus making it possible that it could be reported. Per Medicare NCCI Coding Manual, this procedure would still require a modifier 25 on the E&M.

Be sure the documentation supports a procedure separate from the E&M.

If all they are doing is clearing for surgery, I would have to review the documentation and the situation further to say yea or nay.
 
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