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kathleenl

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Good morning,

New to Optho : Would I need a 25 modifier on the 99214 plus a sep diagnosis when also billing for the 92083 at the same visit?

Any help/guidance is appreciated!

Thanks!

Kathleen
 
No the 25 modifier is not necessary. Please make sure you have a dx to support the visual fields. Are you aware that 92083 is for extended?
 
I put a 25 on all E/M visits or eye codes in which any testing was done. HVF, OCT, Pachyemetry, Gonioscopy, ultrasounds....
 
Plz do not do that as that will surely invite an audit. Normally a diagnostic procedure wld not need modifier 25. If a procedure to treat a condition is done, such as insertion of plugs or retinal injection, it MIGHT warrant a 25 on the E&M.
Think of it as - wld the patient have come if he did not have the problem of dry eyes? Did the doctor address any thing else besides this condition? Hope that helps
 
I am not an expert. At our practice, these diagnostic charges are dropping automatically for us. There is no bundling issue with all 3 CPT. No need for mod 59. They are all good to go.
 
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