Wiki Ekg - service in a facility based

[jaud63]

I am coding an EKG with an E/M service in a facility based Urgent Care Clinic.
A repeat EKG (93005) is being billed. Can this be billed with the repeat modifier or with the 59 modifier?

Additionally, I have been instructed not to use the 25 modifier on the E/M
service (but only for one of the UC locations that I work). How can this be correct?

Please inform.


Thanks

 

[deeva456]

repeat ekgs can be billed with modifiers 76 or 77 depending if the same MD or a different MD read the EKG.

You were told correctly, modifier 25 is not required on an E/M code when an EKG is performed the same day, per CMS. However, there are some payers that ask for a modifier 25.


Dolores, CCC - CPC