Billing ophthalmology

apena

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I was wondering if when billing an office with a procedure, would you also include the modifier 25. Like in billing in the family practice.

Please advise me, I'm new to billing ophthalmology.


Thanks in advance
 

Viviana3

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Billing Representative

You can use mod25 but it will get pay if the DX is different than the procedure 's DX. Otherwise insurance will bundle the office visit. And use the eye OS or OD for on the procedure.

Viviana
 

apena

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correct, it does have a different Dx from the procedure. though, am I required to bill it with the modifier 25. Or will it still get paid without the modifier 25.


thanks in advance.
 
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