hello, my co workers and i are trying to figure out the correct usage of modifier 25.
scenario 1
pt presents for bump on leg, provider decides to to I&D for cellulitis.
we have agreed this qualifies for mod 25 since pt presented with "bump" and procedure was decided on when provider did examination.
scenario 2
pt presents for sore throat, runny nose and chills. provide does strep test, results are positive. she also mentions period missed last month, she would like a pregnancy test.
i do not feel this is significant enough to require a 25, but coworker feels that because test was not part of visit initially, 25 should be added.
are both correct times to use 25? please help!
scenario 1
pt presents for bump on leg, provider decides to to I&D for cellulitis.
we have agreed this qualifies for mod 25 since pt presented with "bump" and procedure was decided on when provider did examination.
scenario 2
pt presents for sore throat, runny nose and chills. provide does strep test, results are positive. she also mentions period missed last month, she would like a pregnancy test.
i do not feel this is significant enough to require a 25, but coworker feels that because test was not part of visit initially, 25 should be added.
are both correct times to use 25? please help!