Wiki djw1975

[dorothy.j.wood@gmail.com]

I know that if we see a patient and order a test the same day we need a modifier for separate E&M but if my neurologist orders multiple tests and then needs to see patient again for test results and further recommendations do I need a modifier for the follow up visit if one of the tests is done the same day as the follow-up.

 

[ValerieBatesHoffCPCCPMA]

Modifier 25

Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service.

Modifier 25 should be assigned to the E/M code to identify that a seperate service was provided in addition to office visit. This tells the insurer you should be paid for both services.

What tests did the physician order? Each insurance is different so it would benefit you to visit there website to see if they have any certain specifications on modifier usage.