AAPC - Back to school
Results 1 to 3 of 3

Thread: modifier 25

  1. #1

    Default modifier 25

    AAPC: Back to School
    Can Someone Please Tell Me If Modifier 25 Can Be Attached To The Crit Care Code 99292 (additional 30 Mins) ???? I Cannot Find It Anywhere!!! Help

  2. #2
    Join Date
    Apr 2007
    Albany, NY

    Default Critical Care and Modifiers

    Here are the Upstate Medicare LCD's for coding and/or modifying critical care. Though you may not be under UMD carrier jurisdiction, these are based on CMS guidelines and should still apply:



    Hope you find what you need!

    Belinda Frisch, CPC

  3. #3
    Join Date
    Apr 2007

    Thumbs up


    You sure can, but there are certain criteria you must abide by before application. First you must read critical care guidelines making sure services being rendered aren’t inclusive of the CC code. Second you must verify that services being rendered in a CC setting aren’t bundled, hence unbundling will cause your claim to be not paid, rejected, denied, or whatever claim status is used to describe a claim submitted with codes unbundled that should be bundled.
    But yes, it is applicable to utilize modifier twenty five when coding E/M code range.

Similar Threads

  1. Replies: 2
    Last Post: 09-18-2015, 01:17 PM
  2. Modifier 59 vs Modifier 91 for Laboratory
    By leahrey in forum Modifiers
    Replies: 1
    Last Post: 06-23-2015, 12:01 PM
  3. MODIFIER PT VS MODIFIER 33 Screening Colonoscopy
    By Ann Johnson in forum Modifiers
    Replies: 2
    Last Post: 07-19-2012, 07:08 AM
  4. Modifier 58 versus Modifier 78
    By Ramona03 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-04-2012, 12:10 PM
  5. Modifier 51 Versus Modifier 59
    By Sborkowski in forum Modifiers
    Replies: 3
    Last Post: 05-26-2009, 03:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.