Wiki Modifier 25

[cperk]

This is a recent subject of debate in my office. A NEW patient is seen for a preventive visit. 99381. A significant and separately identifiable issue is addressed. Would you a new or established patient code in instance for the modifier? Does the number of key elements affect whether or not it would be new or not?

 

[cldavenport]

For the seperate identifiable issue, an established E/M can be used. The number of elements does not determine new or established code selection. The number of elements will help in determining E/M level chosen. You can apply mod 25 to that established E/M code.