Wiki Modifier 25

[loriwise59@yahoo.com]

Hi First time user.

Ok, I have a questions what modifier besides modifier 25 would I use to report two evaluation and management services on the same day. With unrelated diagnosis?

I Google just about everywhere and came up empty: CMS also.


Thanks you

 

[thomas7331]

Generally speaking, the same provider (or two providers of the same specialty) cannot bill two evaluation and management services on the same date of service "unless the physician documents that the visits were for unrelated problems in the office or outpatient setting which could not be provided during the same encounter" (see Medicare claims processing manual chapter 12, section 30.6.7). The guidelines don't specify how to bill this, but I would expect these would routinely deny regardless of the modifier you use and you would need to get payment on appeal if the documentation supports it.