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Wiki Rocephin Inj with office visit

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nelstx2

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Insurance kicked back for

99125-25 466.0, 250.02, 571.5, 782.3
96372-25 466.0
J0694 466.0

what is wrong??? Shouldn't modifier only be on office call??????
 
25 is only for 99 codes 99213, 99214, 99215 etc
Also not all insurance companies will pay the 96372.

25 Significant, seperately identifiable evaluation and management service by the same physician or other qualified health care professinal on the same day of the procedure or other service.

The diagnosis may no matter that it is the same on the office visit. I bill the same dx on ov as the admin and I see payments all the time.

=) Hope this helps
 
Yes. Modifier -25 cannot be on code 96372. Only the office visit 99215. It should be fine other than that. The 466.0 should be fine the way it is.
 
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