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newby here with a mod 25 ???

  1. Default newby here with a mod 25 ???
    Medical Coding Books
    i am brand new to coding, i passed my cpc in March. so please go easy on me. LOL
    i work for a GP in a small office. when some one comes in for an office visit and is having trouble breathing and we do a pulse oximetry. can we attach a mod.25 to the ov? the dr. i work for does most of his own coding. (don't worry i'm working on that issue) right now he has not getting paid at all for this procedure can someone please tell me how i can get some kind of reimbursement for this?

  2. #2
    hai we cant append 25 modifier for pulse ox

  3. Default
    Not many pay for that!

  4. #4
    Greeley, Colorado
    Pulse oximetry is considered part of the E/M and not separately billable.

  5. Default modifier 25
    pulse oximetry is a part of e/m. no 25 modifer

  6. #6
    94760 is considered a bundled code by Medicare and many other payors. However, not ALL payors follow CMS guidelines. For those that do allow separate reimbursement for it, it is perfectly acceptable to append a modifier -25 to the E&M visit.


  7. Default
    Yes. We can bill pulse ox to the payors who allow it with a modifier 25 appended to the E/M.
    Jagadish, CCS-P, CPC

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