Wiki MOD 25

[ACHANES90]

PATIENT COMES IN AS A NEW PATIENT FOR A FOLLOW UP AFTER BEING SEEN AT URGENT CARE FOR A FRACTURE OF HIS FIFTH METATARSAL.
HE IS PLACED IN A CAST IN OUR OFFICE.
WOULD THIS OFFICE VISIT BE APPROPRIATE TO USE MOD 25?

 

[ACHANES90]

ANOTHER SENERIO..

NEW PATIENT COMES IN FOR RIGHT KNEE PAIN DUE TO ARTHRITITS.
PROVIDER PLACES INJECTION OF RIGHT KNEE.
IS THE 25 MOD APPROPRIATE?

99202 25
20610 RT
J3301

 

[csardone]

first scenario - if they are casting a fracture, usually fracture cpt code would be billed instead of office visit. If they are only billing office visit and cast then yes 25 modifier would be correct.
Second scenario - yes used correctly.