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Wiki Cpx & Immun With Mod 25
- Thread starter MsMaddy
- Start date
LOVE2CODE
Expert
Lisa Bledsoe
True Blue
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.
mmorningstarcpc
True Blue
I coded for family practice for years and never used a modifier for E/M and immunications. Never had any problem with any insurance as long as medically necessary.
lfuller
Networker
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
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
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
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