Wiki modifier 25

[valentin]

Can Someone Please Tell Me If Modifier 25 Can Be Attached To The Crit Care Code 99292 (additional 30 Mins) ???? I Cannot Find It Anywhere!!! Help

 

[Belinda Frisch]

Critical Care and Modifiers

Here are the Upstate Medicare LCD's for coding and/or modifying critical care. Though you may not be under UMD carrier jurisdiction, these are based on CMS guidelines and should still apply:

http://www.umd.nycpic.com/cgi-bin/bookmgr/bookmgr.exe/BOOKS/EM002E03/FRONT

http://www.umd.nycpic.com/cgi-bin/bookmgr/bookmgr.exe/BOOKS/EM02E03G/FRONT

Hope you find what you need!

Belinda Frisch, CPC

 

[007CPC]

Yes,

You sure can, but there are certain criteria you must abide by before application. First you must read critical care guidelines making sure services being rendered aren't inclusive of the CC code. Second you must verify that services being rendered in a CC setting aren't bundled, hence unbundling will cause your claim to be not paid, rejected, denied, or whatever claim status is used to describe a claim submitted with codes unbundled that should be bundled.
But yes, it is applicable to utilize modifier twenty five when coding E/M code range.