Question Billing Modifiers 24 and 25 Together?

nicoleysmith

Networker
Messages
31
Best answers
0
We have a patient who had a skin lesion removed. Then the patient came in within that global period for an office visit separate from the skin lesion removal. During this office visit, the patient had an EKG performed. The patient's insurance, Medicare, considers an office visit performed on the same day as an EKG as bundled with the EKG so we have been adding the -25 to show other issues were addressed besides the EKG. Do we need both modifiers -24 and -25 on the office visit? Or is just -24 enough?

99214-24-25
93000

or

99214-24
93000

or

99214-25-24
93000

Please and thank you!
 

shanamarie

Networker
Messages
57
Location
Eagan
Best answers
0
We have a patient who had a skin lesion removed. Then the patient came in within that global period for an office visit separate from the skin lesion removal. During this office visit, the patient had an EKG performed. The patient's insurance, Medicare, considers an office visit performed on the same day as an EKG as bundled with the EKG so we have been adding the -25 to show other issues were addressed besides the EKG. Do we need both modifiers -24 and -25 on the office visit? Or is just -24 enough?

99214-24-25
93000

or

99214-24
93000

or

99214-25-24
93000

Please and thank you!
I believe you would need both modifiers since they are specifying different things. 24 for global period and 25 to unbundle the ekg. I’m not certain on which order the modifiers need to go though.
 

b.cobuzzi

Guru
Messages
156
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0
I agree with shanamarie. I would put the 24 modifier first because you need to break the global first, to even get the payer look at the claim and then you put the 25 so they will look at the em and the ekg.
 
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