Wiki E/M/Modifier

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chavera

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Hello,

I wanted to get some clarification on the billing for a particular scenerio. If a patient has been established for several months in our office and they were originally diagnosed with lets say hypertension and hyperlipidemia by our physician; if the patient is coming in for a recheck on them or for refills or for blood work; can we append the modifier 25 to the E/M code even though there are not really a new problem?

Thanks,

Raquel
 
Modifier 25 is used when a significant, separately identifiable E/M service is performed on the same day as a procedure.

ex: pt comes in to discuss an abnormal pap and the doctor decides to go ahead and do a biopsy.
OR
pt comes in for an in office ultrasound and then talks w/ the doctor about the results.

Mod 25 would be applied to the E/M stating that the service was separate from the procedure.

Karey, CPC
 
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