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using modifier 25 for new patient who is also getting an MRA/MRI

C

closedpurse

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Tampa, FL
how do you handle the decision to perform a MRA/MRI for a new patient being seen in a pain management facility? what are the medicare guidelines for this? would you use the modifier -25 in addition to the new patient office visit?
 
Are YOU performing the MRA/MRI?

If your office is performing the procedure on the same date of service as the visit, then, yes you could append -25 to the visit. Some carriers say they don't need the modifier for a new patient, but most won't pay without it.

F Tessa Bartels, CPC, CEMC
 
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