Modifier Question

[heathergirl]

What modifier would I use when a patient comes in for a shave biopsy, but at the same time receives her Enbrel injection that she brought in

I was going to try 11300 25
90772

But everytime I look at other modifiers- I second guess myself. Please help!


Thanks,

Heather D Unklesbay, CPC, MA
Office Manager

 

[heatherwinters]

Modifier

I believe the modifier 25 can only be used on Evaluation and Management codes. What about a modifier 59 to show it was a distinct service.

 

[Erica1217]

Mod 25 only goes on E&M services.

Becuase the 90772 is bundled into the 11300, you want to use modifier -59 on the 90772.

It would be okay in this case because the injection was a different site and for a different reason.

If the injection had been for local anesthesia for the primary procedure, then it would not be appopriate to use modifier -59.

Hope that helps!

Erica