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Modifier 25 with 92015,92060 and 92225/92226

  1. Default Modifier 25 with 92015,92060 and 92225/92226
    Medical Coding Books
    I am new to opthalmology coding and was instructed by the physician not to use a modifier 25 on the office visit if the codes 92015, 92060 and 92225/92226 are used. I want to be sure this is accurate information. Can anyone help or refer me to documentation supporting this?

    Thanks!

  2. #2
    Default
    We don't use -25 since these are testing services. Modifier -25 is only when procedures are performed. I do the billing for the proffesional side so i am not sure of the technical side of things. Hope this helps.

  3. Default
    Quote Originally Posted by nancydawson View Post
    I am new to opthalmology coding and was instructed by the physician not to use a modifier 25 on the office visit if the codes 92015, 92060 and 92225/92226 are used. I want to be sure this is accurate information. Can anyone help or refer me to documentation supporting this?

    Thanks!

    I'm on the pro side also. You only put mod 25 on the visit when you have a minor surgical procedure on the same day. Not when doing testing.

    On the hospital side, they add a 25 mod to the visit whenever there are diagnostic tests performed.

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