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E/M & diagnostic x-ray: 25 mod on E/M?

  1. #1
    Question E/M & diagnostic x-ray: 25 mod on E/M?
    Medical Coding Books
    Help! Was just handed orthopedic office superbills with E/M visits plus x-rays. Do I need a 25 modifier on the E/M visit or anything on the x-ray besides RT or LT? Or can I put them through 99214, 73560LT (for example)?

    Any help would be greatly appreciated!

    Thank you,

    Sue Haile

  2. Default
    I code for the facility (hospital)...the modifier -25 is generally appended when an edit has been generated between the E&M and a type "S" or "T" procedure on the same date of service.

    CPT 73560 (Type X) would not generate an edit with the E&M therefore no modifier -25 would be necessary.

    Type= Status Indicator

    I am not sure that this is the same logic used on the physician side.
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  3. #3
    Thumbs up thank you
    Thanks for the help. I just couldn't find anything in the CPT book that speaks either way. But the software system we use gives us edits, and it is not giving me an edit, so I was thinking that I didn't need it, but I wanted to be sure.

    Thanks again.

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