99395 with modifier 25

Messages
359
Location
Malone
Best answers
0
If you bill a preventative medicine code (99395) and you did an immunization Tdap and administration, do you bill a modifier 25 on the 99395. I thought that modifier 25 was only for use on 99201-99357. Thanks :)
 

Lisa Bledsoe

True Blue
Messages
2,045
Location
Greeley, Colorado
Best answers
0
Although one would not expect to need a modifier -25 on a preventive code, it seems that more payers are requiring it or the ancillary services won't get paid - like the immunizations. As coders, we are taught not to slap a modifier on everything, but payers won't pay if we don't. Quite a conundrum. :rolleyes:
 

LOVE2CODE

Expert
Messages
392
Location
Alexandria, VA
Best answers
0
If you bill a preventative medicine code (99395) and you did an immunization Tdap and administration, do you bill a modifier 25 on the 99395. I thought that modifier 25 was only for use on 99201-99357. Thanks :)

The answer is no....You would use modifier 25 on 99201-99357 if use on the same visit as the preventive code....


YTH, CPC
 

EARREYGUE

Guru
Messages
141
Location
Loma Linda,CA
Best answers
0
I would not use it, unless the claim comes back requesting a modifier, we were using mod.25 for a while on well checks with vaccines and were told we are over using mod.25 by our compliance dept.
E.A. C.P.C.
 

LOVETAMBRA

Guest
Messages
11
Best answers
0
Modifier 25

I have a patient who came in for a well woman and IUD removal, should I use the 25 modifier on the 99395?
 
Top