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Modifer 25 with annual exam

  1. Default Modifer 25 with annual exam
    Medical Coding Books
    NP annual exam comes to the office for gyn. Pt has annual but also has other issues. Physician documents properly and 25 modifer is placed on the E&M. Is it correct coding that the E&M used with the modifier should be an established E&M code with a new patient annual exam code?

  2. #2
    Greeley, Colorado
    That is my interpretation, but others on the forum state both can be new. It really will depend on the carrier.
    Lisa Bledsoe, CPC, CPMA

  3. Smile modifier 25
    We have been billing a 25 modifier on the E&M along with a physical and we do receive payment. There are very few insurance companys that are not paying.

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