Wiki Mod 25 and Mod 59

[cmontgomery]

A patient with high blood pressure and hyperlipidemia is seen by the doctor and has their blood drawn. Would you bill out the E&M with a mod 25 and link to
the bp and then bill out the blood draw with a 59 linked to its own diagnosis code hyperlipidemia? Would you use any mods at all? We have been billing out ex 99212-25 with 401.1 and 36415-59 with the 272.4. Is this how ya'll do it out there?

 

[tammyross]

-25 & -59

To my knowledge, I wouldn't use any modifiers on either one of these codes. Let's say, though, the patient came in with knee pain and there was an injections preformed. I would bill the office visit with -25 attaching HP and hyperlipidemia diagnosis and the knee pain diagnosis to the injection code.
Hope this helps!

 

[shruthi]

E&M with venipuncture does not require any modifier. Also we can bill E&M and 36415 without any modifier as per CCI edits.

Regards,
Shruthi.