Wiki E/M with vaccines

[Lanie Christman]

I just started working in a new practice and I have a question concerning modifier 25. In my old practice-we added modifier 25 if the patient had an office visit and vaccines. Adding the modifier to the E/M code. In my new practice--they do not do this...does anyone add or Not add the modifier when billing for an office visit and vaccines.
Thank you for your help!

 

[ASH527]

Modifier 25

I Do Add The Modifier 25 To The E/m Code When A Vaccine Is Administered & I Don't Have A Problem

 

[Lanie Christman]

Thank you!!

 

[HHaman]

25 on E/M w/ vaccines

We add a 25 on the E/M code also with our vaccines. Has been working well for us.

 

[FTessaBartels]

Significant, Separately Identifiable E/M

Please Note: the -25 modifier is used to identify a Significant, Separately Identifiable E/M service.

That means that if the patient is presenting to the office JUST FOR the vaccine there is no separately identifiable E/M!

If the patient presents with a complaint, and it's determined that it's appropriate to also give a vaccine at this visit, THEN you have a reason to code an E/M with -25 modifier in addition to the vaccine administration.

F Tessa Bartels, CPC, CEMC

 

[Lanie Christman]

In most cases, baby is presenting for well visit-and vaccines are administered.