CMart11
New
Hi Everybody,
I am the Administrator for an outpatient Neurology practice and my doc asked me to clarify something so I wanted to reach out for some opinions. We perform routine EEG in our office (either CPT 95816 or 95819) often the same day as the patient's office visit (usual outpatient E/M codes 99214, 99205 etc). I have been here for 3.5 years and my doc has been here for almost 6, and we have never appended modifier 25 to the E/M when doing EEG same day, and we have never had an issue with reimbursement. Her question is, should we be appending modifier 25 to the E/M? Are we at risk of getting audited and having to pay back $$ from improperly coded visits and EEGs? Thanks in advance!
I am the Administrator for an outpatient Neurology practice and my doc asked me to clarify something so I wanted to reach out for some opinions. We perform routine EEG in our office (either CPT 95816 or 95819) often the same day as the patient's office visit (usual outpatient E/M codes 99214, 99205 etc). I have been here for 3.5 years and my doc has been here for almost 6, and we have never appended modifier 25 to the E/M when doing EEG same day, and we have never had an issue with reimbursement. Her question is, should we be appending modifier 25 to the E/M? Are we at risk of getting audited and having to pay back $$ from improperly coded visits and EEGs? Thanks in advance!