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Add -25 when EKG or Injection done?

  1. #1
    Location
    Salt Lake North
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    637
    Cool Add -25 when EKG or Injection done?
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    Patient comes into the clinic and has an office visit. Dr. does either an EKG or B12 injection. I am being told that we do not have to use the modifier on the office visit since an actual PROCEDURE was not done. How are you doing it and what are your results? If you bill an office visit and EKG without a -25 modifier is it being paid or denied? Having a problem with the billing office. Thanks!

  2. #2
    Smile mod 25 for injections
    In my experience you will append modifier 25 when you do an injection, however not when you do an EKG. Good luck.

  3. Default
    When billing for Medicare, 25 modifier should be appended to an E/M when you bill a procedure having 0 or 10 global days. EKG and B12 injection both has global days indicator as XXX. For certain commercials, they need a modifier with E/M along with EKG and Injection. In any of the case, E/M service should be irrelevant to the procedure done or should be above and beyond the normal preop component for the procedure done.
    Thanks,
    Jagadish, CCS-P, CPC

  4. #4
    Location
    Salt Lake North
    Posts
    637
    Default
    Thank you for your help!

  5. Default Global Days?
    Where can we find out the global days of the procedures such as the EKG and different injections, etc.?

  6. #6
    Default
    Quote Originally Posted by mgeiser View Post
    Where can we find out the global days of the procedures such as the EKG and different injections, etc.?

    Medicare Physician Fee Schedule Look-up tool. Although for these procedures don't typically have a global period.
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  7. #7
    Thumbs up
    Thanks for the info on the link. Good to know.

    Peace
    @_*




    https://www.cms.gov/Medicare/Medicar...-1654-CN4.html

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