Cpx & Immun With Mod 25

MsMaddy

Guest
Messages
232
Best answers
0
Hello,

I wanted to know if anyone knows if it is ok to use mod 25 to office level
when pt comes in for cpx and get immunization or injections ?

Example

99392-25 prevenative coed
90715- td immun
90471- admin inj

Please Help

Thanks
 

MsMaddy

Guest
Messages
232
Best answers
0
Hello,

I wanted to know if anyone knows if it is ok to use mod 25 to office level
when pt comes in for cpx and get immunization or injections ?

Example

99392-25 prevenative coed
90715- td immun
90471- admin inj

Please Help

Thanks[
 

Lisa Bledsoe

True Blue
Messages
2,045
Location
Greeley, Colorado
Best answers
0
Depends on the payer. For some if you don't use mod -25 on the preventive they will not pay for the administration codes. We do add -25 to our preventive codes. These codes are in the E/M section of CPT so are technically evaluation and management codes.
 

MsMaddy

Guest
Messages
232
Best answers
0
Thank You

Thank you both, so now I'm not sure because because one is saying it OK to use and the other is saying no. I'd like more response regarding this issue.

msmaddy
 

mfn1974

Contributor
Messages
18
Best answers
0
Admin w/ CPE

I agree with Lisa. It depends on your payer. We have seen the admin bundled in with the OV/CPE.
 

lfuller

Networker
Messages
31
Best answers
0
we also use -25 on e/m including preventive codes. If you look under the
imm admin section of CPT, it says " if significant separately identifiable E/M
service (office, preventive med) the appropriate E/M service code should be
used in addition to vaccine" that's not a word for word quote. Anyway, the
ins co I work with have homed in on the "separately significant " part and are
using it to require -25 on E/M, since mod -25 says "significant,separate".
At least, that's what the companies tell me.
Linda,
Reedsburg,WI
 

dmaec

True Blue
Messages
1,133
Location
Duluth, Minnesota
Best answers
0
I agree with, Lisa, mfc2003 & lfuller - to use the .25 modifier.
We use the .25 on the E/M's/preventive service when immunizations are given. It is a "separately identifiable" procedure along with the preventive service.
Donna :)
 

MsMaddy

Guest
Messages
232
Best answers
0
thank you

I thank you all who responded to my question on modifier 25. I think I will start using it and see what happens.

MsMaddy:) :)
 
Top