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Modifer 25 and Injections

  1. #11
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    Medical Coding Books
    If the only reason the patient is coming in is for the injection, bill the med and the administration code only.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

  2. #12
    Default
    You indicate that you think a 25 modifier needs to be applied to the E/M code. We don't charge for the administration injection codes when the patient also sees a provider on the same date. You would then only charge the E/M (no modifier needed) and injection(s).
    Jutta Whipkey, CPC

  3. #13
    Default
    You cannot bill the nurse visit 99211 with the therapeutic injection 90772 (which is actually 97632 for this year 2009) because this injection is given with direct physician supervision where as the nurse vist 99211 is stating without physician supervision. So I would not append a modifier 25 or report the nurse visit 99211 at all with this particular injection code.

    Hope this helps...
    TJ Smith, CPC
    Cheyenne Physicians Group
    Cheyenne, WY

  4. #14
    Location
    Columbia, MO
    Posts
    12,867
    Default
    That is correct, you do not report the 99211 to give an injection because the code is for the administration of the serum which includes all nursing management and supervision.

    Debra A. Mitchell, MSPH, CPC-H

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