Wiki E/m with ekg/nebulizer

[jgielow]

I work in a family care office, and was questioning the proper use of the modifier 25. If we see a patient in the office due to chest pain and the provider deems it medically necessary to perform and read an EKG (93000), do we need a modifier 25 to the office visit, or is considered bundled?

Or, if we see a patient for an URI, and the provider deems it medically necessary for them to receive a nebulizer treatment can we bill for the office visit with modifier 25 and the nebulizer treatment (94640)? Or is that unbundling?

Please help!!!

 

[jenneverett]

An EKG with the visit

I work for a cardiology practice and we do EKG's at the time of office visits often and we have been reimbursed for the visit and the ekg on the same claim without a 25 modifier on the visit.

Hope that helps!

Jenn

 

[jgielow]

Thank you, that was exactly what I needed to know, I started over thinking

 

[espressoguy]

I think Aetna and, maybe, Cigna want a 25 on the E&M.