Wiki 99292

[rnyazz]

Good afternoon,
Can someone assist me with this question? Can I add a modifier 25 to 99292 add on code? the modifier 25 is already applied to the 99291. Recieving a denial because the 99292 does not have a modifier. the 36556 is also applied.
thanks

 

[donnalynn]

Good afternoon,
Can someone assist me with this question? Can I add a modifier 25 to 99292 add on code? the modifier 25 is already applied to the 99291. Recieving a denial because the 99292 does not have a modifier. the 36556 is also applied.
thanks

Is the denial from Medicare?

Per Medicare - The critical care codes, 99291(30-74 minutes) and 99292 (each additional 30 minutes), are used to report the direct delivery by a physician(s) of medical care for a critically ill or critically injured patient. When submitting a claim for these services during a global surgery period the provider must append modifier 25 to each code.

If not Medicare I would still apply modifier 25 to 99292

I hope this helps!

 

[rnyazz]

Thank you very much! This is helpful.... I just can't locate the link or find the article where it indicates append the modifier 25 to "each code. "

 

[donnalynn]

Thank you very much! This is helpful.... I just can't locate the link or find the article where it indicates append the modifier 25 to "each code. "

here is one link that refers to Medicare Part B:

https://www.noridianmedicare.com/cg...u&tmpl=part_b_viewnews&style=part_ab_viewnews

You can also find this information on the CMS website

I have coded ED critical care charts for 14 yrs and coded 99292 with a modifier 25 (if applicable) and never had a problem!