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modifier 25 and preventive codes

  1. Default modifier 25 and preventive codes
    Medical Coding Books
    I was always told not to append a modifier 25 on a preventive service, now it seems more and more third party payers are wanting the modifer when age appropriate immunization are given. Is there a steadfast rule on this or is this simply up to the third party payer. I would appreciate any clarification on this.

  2. #2
    Charlotte, NC
    I would recommend polling your payers (or otherwise reviewing their reimbursement policies) to determine the correct use of modifier -25. I've seen a variety of methodologies, and they've varied by carrier. HTH!

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