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Modifier 25 on Critical Care Codes

  1. Cool Modifier 25 on Critical Care Codes
    Medical Coding Books
    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
    I would think you would only need it on the 99291.
    Walker Bachman, CPC, CPPM

  3. Default
    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. Default
    Cathy, Walter...thanks for your replies.

  6. #6
    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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