Mod 25 w/ Strep or UA Dipstick

weevily

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Hi, I am hoping someone can help me. I am looking for some documentation that proves it is acceptable to use the mod -25 on a e/m when doing a ua dipstick or a throat rapid strep. For example when coding 99213 and 81002. Thanks.
 

Leandra

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Are you having trouble getting the labs paid? We don't use modifier 25 when billing labs with an OV - I'm not sure about any documentation stating that you can bill like that.
 

weevily

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Yes, they are denied. This is the dipstick and rapid streps done in the office. I was told they need a -25, but I do not feel comfortable without documentation.
 
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You don't need that modifier for a UA w/ OV - what insurance denied? Now HAP is making the UA inclusive to the OV.

:)
 

weevily

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The ones I have so far are blue cross. I appriciate the help.
 
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