Wiki 25 modifier

[Karalea88]

Is it appropriate/necessary to bill modifier 25 with E/M code when CPT 36415 (lab drawn) is done during the visit? Or is the it not necessary?

 

[trarut]

It's not necessary and, my opinion, would not be appropriate. Also, some plans - Aetna, I'm lookin' at you! - bundle the draw code when any other service is performed the same day. They simply won't pay for it.