Wiki MOD 25 on office visit w/ closed FX care

[Kaitbohrer]

Is anyone else having their office visits w/ mod 25 denied with Fracture care code?

Easy example:
99203-99204-25 - office visit with mod 25 for in ofc minor surgery
25600 LT - fracture care
Q4010 - cast supplies
NO Casting charge I'm aware
73110 - xray charge


I am getting so many mixed answers - " You can code office visit with fxcare" AND "You CANT code office visit with fxcare" WHAT IS IT!!!!

 

[EricLam88]

Is anyone else having their office visits w/ mod 25 denied with Fracture care code?

Easy example:
99203-99204-25 - office visit with mod 25 for in ofc minor surgery
25600 LT - fracture care
Q4010 - cast supplies
NO Casting charge I'm aware
73110 - xray charge


I am getting so many mixed answers - " You can code office visit with fxcare" AND "You CANT code office visit with fxcare" WHAT IS IT!!!!

Did you use a different ICD-10 for the office visit?

The Modifier 25 is defined as a significant, separately identifiable Evaluation and Management (E/M) service by the same physician or other qualified health care professional on the same day of a procedure or other service.


In my experience as a biller and coder, insurance usually pays the modifier 25 with a different ICD-10 that is different to the fx care codes.

 

[cling2me2]

Hi.
CPT 25600 has a 90 day global period and therefore would need modifier 57 on the E&M code.

 

[ashleijackson]

Hi.
CPT 25600 has a 90 day global period and therefore would need modifier 57 on the E&M code.

Agree with this! Add 57 modifier to the ov.