Modifier 25

thomas7331

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Modifier 25 indicates E&M that is separate from a procedure performed on the same date. What procedure was billed your situation, and per the documentation, was the 'lengthy discussion' related to that procedure or not?
 

chantal777

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Modifier 25 indicates E&M that is separate from a procedure performed on the same date. What procedure was billed your situation, and per the documentation, was the 'lengthy discussion' related to that procedure or not?
The lengthy discussion was only to discuss the ultrasound findings. I have never use modifier 25 for this purpose before. To me discussing test results with a patient is part of the ordering test. The new E/M guidelines states it clearly.
 

thomas7331

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The lengthy discussion was only to discuss the ultrasound findings. I have never use modifier 25 for this purpose before. To me discussing test results with a patient is part of the ordering test. The new E/M guidelines states it clearly.
The discussion of results is part of the E/M, yes, so you can count that time toward the total time of the E/M, or count it toward the MDM, as appropriate. But that's a completely separate issue from the use of modifier 25. I guess I'm not sure I actually understand what you're asking here.
 
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The lengthy discussion was only to discuss the ultrasound findings. I have never use modifier 25 for this purpose before. To me discussing test results with a patient is part of the ordering test. The new E/M guidelines states it clearly.
I agree. But if this was an office visit perhaps you could bill based on time?
 
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