Wiki Modifier 25 on Critical Care Codes

[msmaireb]

I've received conflicting answers regarding this question. Any feedback is appreciated.

Patient is 99291 and 99292 with an EKG – do you add -25 to both E/M's or just the 99291? This is professional fee emergency department coding.

Thanks,
Mary B., CPC

 

[Walker22]

I would think you would only need it on the 99291.

 

[msmaireb]

That's what I thought, too. But I've got several co-workers who say it goes on both...and I don't believe that to be the case.

 

[coding?4u]

99292 being an add on code should not require mod 25.

Cathy from Va

 

[msmaireb]

Cathy, Walter...thanks for your replies.

 

[OCD_coder]

This is a late posting to this thread as the information is incorrect. A -25 modifier should never be used with medicine codes. The modifier -25 should only be used with global periods of between 0-10 days, these are on surigial codes (i.e. lac repair, I/D's etc.).

If a modifier is needed w. Critical Care for a surgical procedure you would put it on both the 99291 and 99292 as they are inclusive together.