Wiki modifer with S0257

olgunchik

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Does anyone know what modifer we should use with S0257 (advanced directive counseling) ? Thank you.
 
"S0257 denied as payment adjusted because the procedure modifer as invalid on the date of service". This was denial.
S0257 was billed with office visit and mod 25 attached to OV.
Thanks
 
"S0257 denied as payment adjusted because the procedure modifer as invalid on the date of service". This was denial.
S0257 was billed with office visit and mod 25 attached to OV.
Thanks

Was this billed to Medicare or a commercial payer? Medicare does not pay for this code ever. Commercial payers may not either, you would need to check with the plan. The code indicates counseling and discussion regarding advance directives or end of life care planning and decisions. It is likely not a separately covered service, so that is why the modifier was incorrect.
 
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