59 modifier on 96372 for E/M with EPO injection

[Tonyj]

I was advised to use the 59 modifier on 96372 for admin of Epo (J0885) on the office visit of 99215-25. I just need to confirm if this is correct. It was my understanding that the 25 modifier on the E/M was sufficient.

 

[Pam Warren]

Some payers want the -25 on the E&M at the same time as a therapeutic injection, but correct coding tells us we do not need a modifier at all. In any case, the -59 would not be appropriate. That's used for two or more procedures, and E&M is not considered a procedure.

 

[Tonyj]

Some payers want the -25 on the E&M at the same time as a therapeutic injection, but correct coding tells us we do not need a modifier at all. In any case, the -59 would not be appropriate. That's used for two or more procedures, and E&M is not considered a procedure.

Thanks Pam