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Thread: Modifier 25 on Critical Care Codes

  1. #1

    Cool Modifier 25 on Critical Care Codes

    AAPC: Back to School
    I've received conflicting answers regarding this question. Any feedback is appreciated.

    Patient is 99291 and 99292 with an EKG – do you add -25 to both E/M’s or just the 99291? This is professional fee emergency department coding.

    Mary B., CPC

  2. #2
    Join Date
    Apr 2007
    Athens, Ga.


    I would think you would only need it on the 99291.
    Walker Bachman, CPC, CPPM

  3. #3


    That's what I thought, too. But I've got several co-workers who say it goes on both...and I don't believe that to be the case.

  4. #4


    99292 being an add on code should not require mod 25.

    Cathy from Va

  5. #5


    Cathy, Walter...thanks for your replies.

  6. #6
    Join Date
    Apr 2007
    Nashville AAPC Chapter


    This is a late posting to this thread as the information is incorrect. A -25 modifier should never be used with medicine codes. The modifier -25 should only be used with global periods of between 0-10 days, these are on surigial codes (i.e. lac repair, I/D's etc.).

    If a modifier is needed w. Critical Care for a surgical procedure you would put it on both the 99291 and 99292 as they are inclusive together.

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