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Mod 25 and Mod 59

  1. #1
    Default Mod 25 and Mod 59
    Medical Coding Books
    A patient with high blood pressure and hyperlipidemia is seen by the doctor and has their blood drawn. Would you bill out the E&M with a mod 25 and link to
    the bp and then bill out the blood draw with a 59 linked to its own diagnosis code hyperlipidemia? Would you use any mods at all? We have been billing out ex 99212-25 with 401.1 and 36415-59 with the 272.4. Is this how ya'll do it out there?

  2. #2
    Macon, Georgia
    Smile -25 & -59
    To my knowledge, I wouldn't use any modifiers on either one of these codes. Let's say, though, the patient came in with knee pain and there was an injections preformed. I would bill the office visit with -25 attaching HP and hyperlipidemia diagnosis and the knee pain diagnosis to the injection code.
    Hope this helps!
    Tammy Held, CPC, CPPM

  3. Default
    E&M with venipuncture does not require any modifier. Also we can bill E&M and 36415 without any modifier as per CCI edits.


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