Wiki Multiple 25 Modifier

[my2seasons]

Per NCCI and CMS, as of 1/1/13, our office is required to append a -25 modifier to the Well OV when billed with shot administration(s). If we also bill a Sick OV with the Well OV plus shots, do we need to append a 25 modifier to the Sick OV as well? That would mean we are using two -25 modifiers on the same claim. Any help/input would be greatly appreciated!!! Thanks!

 

[btadlock1]

Per NCCI and CMS, as of 1/1/13, our office is required to append a -25 modifier to the Well OV when billed with shot administration(s). If we also bill a Sick OV with the Well OV plus shots, do we need to append a 25 modifier to the Sick OV as well? That would mean we are using two -25 modifiers on the same claim. Any help/input would be greatly appreciated!!! Thanks!

I've never understood why people think that you can't use a -25 modifier on 2 codes at once, but yes, you can. If you have an injection administration (96372), billed with a sick visit and a well visit, both E/M's will require a -25 modifier to process. Hope that helps!

 

[my2seasons]

I agree...there's no documentation stating we can't use it more than once...we just never have before. I just needed that reassurance from a fellow coder. Thank you very much!!!