Wiki E/M with 25 modifier

[kathy073]

Hi!

in this scenario would a 25 modifier be appropriate:

Patient comes in for 3 month followup. Patient is seen for numerous chronic problems, including DM, HLD, and HTN. Dr does an EKG for chest pain. is 25 modifier required on the OV for the EKG?

also, if the patient also has an AK cryo'd same day, is a 59 modifier required on the EKG, since the 25 modifier would indicate the cryo?

thanks for your help.

 

[pscott]

I use the 25 mod for the ekg and the cyro. I have not used a 59 in this scenario,
and have never heard of a problem.

 

[stheck]

I don't see why it would hurt to use the -25 and the -59. However, it is kind of obvious that each service is distinct, the office visit isn't done for chest pain, meaning the visit was intended as a follow up for pts chronic conditions, and patient happened to mention that they were having chest pain. I would however, use the -59 on the second procedure (whichever one has lower RVU's should be listed last, probably the EKG).

Ex:

99214 - 25 , 250.xx, 272.xx, 401.xx, 786.50
17000 (for first lesion) 702.0
17003 (for additional lesions) 702.0
93000 - 59 , 786.50