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Wiki modifier 25 - pediatric clinic physicians

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Priscilla Keogh

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My pediatric clinic physicians do several well child visits a day. I have had some claims come back wanting a modifier 25 on the preventive medicines code because a fluoride treatment or some other service was done at the same time. Has anyone else had this happen, is appending modifier 25 the correct thing to do? Appreciate any comments:o
 
Hello how are you? I code/bill for high risk pregnancy physicians; from my experience I do know some insurance are sticklers for 25 modifiers. When billing E/M code only with a procedure certain insurance still require 25 mod on OV. When E/M is billed with U/S you can attached the follow , ex: 76811-59, and 99212-25. Hope this helps. Have a good one.
 
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