WendySPeters
Guest
We have a couple claims that have modifier 25 on them that the physician and I agree on however, we want to be sure we are thinking correctly.
1 scenario is a patient comes in to have a hemagioma removed from ear. our coder billed E&M w/modifier and the excision code. The physician and I do not think the modifier should have been used nor should the E&M have been billed.
2. same scenario as far as I'm concerned is pt comes in for drainage of elbow notes state specifically he withheld meds for this procedure. NO modifier as far as I'm concerned coder appended w/modifier 25.
3. different scenario pt. comes in for eyelid issues while provider is examining pt she discovers irritated skin tags, and actinic keratosis. Provider decides to use cryotherapy x3 E&M was appended w/modifier 25 however ALL diagnosis were entered on both line items. My knowledge is the modifier is correct in this scenario however, the skin tag and keratosis should not be on the E&M.
Please advise on how we should have billed these three visits. so I can pass info on to my physician.
Thank you very much
Wendy
1 scenario is a patient comes in to have a hemagioma removed from ear. our coder billed E&M w/modifier and the excision code. The physician and I do not think the modifier should have been used nor should the E&M have been billed.
2. same scenario as far as I'm concerned is pt comes in for drainage of elbow notes state specifically he withheld meds for this procedure. NO modifier as far as I'm concerned coder appended w/modifier 25.
3. different scenario pt. comes in for eyelid issues while provider is examining pt she discovers irritated skin tags, and actinic keratosis. Provider decides to use cryotherapy x3 E&M was appended w/modifier 25 however ALL diagnosis were entered on both line items. My knowledge is the modifier is correct in this scenario however, the skin tag and keratosis should not be on the E&M.
Please advise on how we should have billed these three visits. so I can pass info on to my physician.
Thank you very much
Wendy
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