Coder_Rick
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Good morning all!
Should Mod 25 be used with an office visit and G0121 for Medicare?
Should Mod 25 be used with an office visit and G0121 for Medicare?
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Wiki Mod 25 and G0121...
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Why are you coding an office visit with a colonoscopy screening on the same visit? Normally, you have to prep for a colonoscopy so just curious is all. I haven't ever coded an E/M level with my colonoscopies on the same day with an office visit for my general surgeon.
Otherwise, to answer your question, G0105 Colorectal cancer screening; colonoscopy on individual at high risk and G0121 Colorectal screening; colonoscopy on individual not meeting criteria for high risk are both for Medicare.
If there is a procedure performed at the same time as an office visit, depending on the documentation and what supports it, then yes, you would need a 25 modifier on the E/M level.
Otherwise, to answer your question, G0105 Colorectal cancer screening; colonoscopy on individual at high risk and G0121 Colorectal screening; colonoscopy on individual not meeting criteria for high risk are both for Medicare.
If there is a procedure performed at the same time as an office visit, depending on the documentation and what supports it, then yes, you would need a 25 modifier on the E/M level.
Coder_Rick
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Thank you!
Something didn't gel right with me on this, thank you for clearing it up!
Something didn't gel right with me on this, thank you for clearing it up!
So guess they do both at times lol! They just prepped the patient and admitted him until his procedure.syllingk
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Medicare won't pay for an office visit prior to a colonoscopy for screening unless it is a personal history. I can't remember right now if they will pay for the visit if it is high risk for family reasons.