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Thread: Modifier 25

  1. #1
    Join Date
    Apr 2007
    Location
    Kachina Coders
    Posts
    51

    Default Modifier 25

    I have a question regarding Modifier 25 with the use of 99291 and 99292.

    Can someone please let me know if you need to use modifier 25 on the 99291 when also using 99292?
    Cynthia
    Mesa, AZ
    CPC

  2. #2

    Default

    No, 99292 is an add-on code. You must use 99291 first then 99292.
    Hope this helps!
    Stephanie, CPC, HCS-D

  3. #3
    Join Date
    Apr 2007
    Location
    Kachina Coders
    Posts
    51

    Default

    Thank you, the biller in our department added modifier 25 on to my code and when asking her why she did that she stated the insurance companies in the past have request a modifier. I am unaware of any insurance compay that would request this but who knows.
    Cynthia
    Mesa, AZ
    CPC

  4. #4

    Default

    If that's the case then it needs to be taken up with the insurance company. I've always been told that you DON"T add modifiers onto add-on codes. That should be appealed if that was the case.
    Stephanie, CPC, HCS-D

  5. #5
    Join Date
    Apr 2007
    Location
    Milwaukee WI
    Posts
    4,453

    Default Separate procedure?

    The only time you should need a -25 modifier on 99291 (AND 99292) would be if you had a separate procedure, such as intubation or chest tube.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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