igord09
New
Hello All,
So our Family Practitioner did a preventive visit for a new patient (99385), and included a new patient E/M code (99201) for autism, and added a modifier 25 to the E/M code, which is correct. But then he also did a glucose blood test with a monitoring device (82962) because the patients mother was worried about the patient having diabetes because of poor eating habits, but provider confirms that the patient does not have diabetic symptoms. So the provider put a modifier 25 on the preventive visit code, stating he needs the modifier on the preventive visit for the glucose test. From what I understand, he doesn't need a modifier 25 on the preventive visit for the glucose test. Could someone please clarify if he does need the modifier on the preventive visit for the glucose test? Or if he can bill the glucose test at all?
99385-25
82962
99201-25
Also our provider is putting a modifier 25 on a established patient E/M code because of the ECG he performed with interpretation (93000) for the established hypertension the patient has, "diagnosed two years ago" per chart note. The E/M portion is for CKD. Does he need the modifier 25 on the E/M code for the ECG (93000)? Can he bill for the ECG if the hypertension is a existing problem?
99203-25
93000
So I need to know if modifier 25 is appropriate for these 2 specific situations. Any feedback is appreciated!
Thanks!
So our Family Practitioner did a preventive visit for a new patient (99385), and included a new patient E/M code (99201) for autism, and added a modifier 25 to the E/M code, which is correct. But then he also did a glucose blood test with a monitoring device (82962) because the patients mother was worried about the patient having diabetes because of poor eating habits, but provider confirms that the patient does not have diabetic symptoms. So the provider put a modifier 25 on the preventive visit code, stating he needs the modifier on the preventive visit for the glucose test. From what I understand, he doesn't need a modifier 25 on the preventive visit for the glucose test. Could someone please clarify if he does need the modifier on the preventive visit for the glucose test? Or if he can bill the glucose test at all?
99385-25
82962
99201-25
Also our provider is putting a modifier 25 on a established patient E/M code because of the ECG he performed with interpretation (93000) for the established hypertension the patient has, "diagnosed two years ago" per chart note. The E/M portion is for CKD. Does he need the modifier 25 on the E/M code for the ECG (93000)? Can he bill for the ECG if the hypertension is a existing problem?
99203-25
93000
So I need to know if modifier 25 is appropriate for these 2 specific situations. Any feedback is appreciated!
Thanks!