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Wiki E&M w/labs question

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Pam Baker

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I have not done family practice coding for about 10 years (since have been doing orthopedics w/no labs). I am helping out a family practice clinic and wanted refresh my memory as to whether to use a modifier 25 on the E&M code if also billing a venipuncture, UA, or any other form of labs. Please help my memory. Don't remember having to do that with labs 10 years ago!!
 
Not usually

You do not usually have to append a modifier 25 to the office visit when performing labs at an office visit. Aetna is the only plan I know of that will only pay for a UA when modifier 25 is appended to the E/M. Most others do not require it though! Hope that helps!
Allyson Martin, CPC, CMC
 
Thanks for the heads up. They were telling me at their office that you do and I thought it sounded a little odd, not quite what I remembered, but it has been a while. Appreciate the answer and help!!
 
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