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Modifier - Ok I know

  1. Question Modifier - Ok I know
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    Ok I know this is kind of a stupid question. But I have several different people telling me to do different things. Our doctor saw a patient in consult (99244)for a abscess on her thigh, he took her over to the hospital the same day to do an i&d (10061). Should a 25 or a 57 be put on the office visit. I was going to put a 25 but someone else said I should use a 57. So now I'm confused. Any help would be great!

  2. #2
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    Duluth, Minnesota
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    the .25
    the 10061 has a 10 day global. If it had, say a 90 day global and was a MAJOR surgery - you'd use the .57

    but - it's not..it's a minor procedure and if you code the consult you'd use the modifier .25 on it because of the MINOR 10day global procedure being done (documentation supporting both services of course)

    ohh..and, no such thing as a stupid question!
    Donna, CPC, CPC-H

  3. Default
    Thank you!!! That's what I thought, but someone else was thinking a 57 was better. Thanks so much!

  4. #4
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    Duluth, Minnesota
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    you're welcome
    Donna, CPC, CPC-H

  5. #5
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    Quote Originally Posted by baileca View Post
    Ok I know this is kind of a stupid question. But I have several different people telling me to do different things. Our doctor saw a patient in consult (99244)for a abscess on her thigh, he took her over to the hospital the same day to do an i&d (10061). Should a 25 or a 57 be put on the office visit. I was going to put a 25 but someone else said I should use a 57. So now I'm confused. Any help would be great!
    Baileca-Please know that NO QUESTION IS STUPID....I learn something new EVERYDAY in this business and I have been doing it over 20 years.....

    To answer your question modifier 25 is the one you want to use.
    Yolanda T. Haskins CPC, CRC, OHCC, AAPC Fellow
    Past AAPCCA Board of Directors 2014 - 2017


    Alexandria, VA Chapter

    ~ Practice Kindness ~

  6. Default
    Thank you so much! Your right there are no stupid questions!

  7. #7
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    CHERRY HILL
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    My only comment is to check the operative report or check with your surgeon, if the abscess was deep you could bill 27301 (instead of 10061)which would then need require a -57 on the consult because it has a 90 day global period. If you are using 10061 then -25 is correct.

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