critical care

[sam_son]

hai
could any one clarify me, while we using 99291 & 99292 , if any separately identifying procedure is done we are using modifier 25 with 99291 , do we need to use/link modifier 25 again with 99292.
Regards
Samson

 

[renifejn]

yes, you do

 

[sam_son]

thank you for your reply , could i get any documentation for this ?
regards
samson

 

[Lisa Bledsoe]

I'm curious why you would need to use -25 on 99292 when you've already used it on 99291...

 

[renifejn]

Some services are reported as add-on codes (99292), which describe work done in addition to primary procedures. Add-on codes are not stand-alone codes, and must always be reported with primary procedures. When correct coding indicates the use of a modifier is appropriate for the primary code, that modifier must be appended to both the primary code and add-on code.

 

[Lisa Bledsoe]

Forgive me for asking...I have never heard of that before. Can you please direct me to that guideline?

 

[rachelefporter]

pls don't use -25 w/99292
-25 is added to 99291 & pls see crit care guidelines for which procedures are already bundled into the crit care E/M codes

Some services are reported as add-on codes (99292), which describe work done in addition to primary procedures. Add-on codes are not stand-alone codes, and must always be reported with primary procedures. When correct coding indicates the use of a modifier is appropriate for the primary code, that modifier must be appended to both the primary code and add-on code.

 

[renifejn]

why not put it on 99292 as well?

 

[Lisa Bledsoe]

pls don't use -25 w/99292
-25 is added to 99291 & pls see crit care guidelines for which procedures are already bundled into the crit care E/M codes

THANK YOU RACHELE!!

 

[sam_son]

Hay guys
please give me a solution one saying to use and other saying not to use, please guide me
regards
samson

 

[Lisa Bledsoe]

Samson - you should not need a -25 on 99292. That being said, some payers may require it because they like to create their own rules.

 

[FTessaBartels]

We use -25 on 99292

It may seem evident that you shouldn't need it, but the hard reality is that the carriers sometimes won't pay without it.

We use the -25 on both the 99291 and 99292 when there's a separately identifiable procedure from the critical care, and we get paid.

F Tessa Bartels, CPC, CPC-E/M

 

[ptrautner]

I heard that Medicare won't typically pay for the 99292 anyway