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Cpx & Immun With Mod 25

  1. Smile Cpx & Immun With Mod 25
    Medical Coding Books
    Hello,

    I wanted to know if anyone knows if it is ok to use mod 25 to office level
    when pt comes in for cpx and get immunization or injections ?

    Example

    99392-25 prevenative coed
    90715- td immun
    90471- admin inj

    Please Help

    Thanks

  2. Default
    [QUOTE=madlen;15516]Hello,

    I wanted to know if anyone knows if it is ok to use mod 25 to office level
    when pt comes in for cpx and get immunization or injections ?

    Example

    99392-25 prevenative coed
    90715- td immun
    90471- admin inj

    Please Help

    Thanks[

  3. #3
    Smile
    [QUOTE=madlen;15517]
    Quote Originally Posted by madlen View Post
    Hello,

    I wanted to know if anyone knows if it is ok to use mod 25 to office level
    when pt comes in for cpx and get immunization or injections ?

    Example

    99392-25 prevenative coed
    90715- td immun
    90471- admin inj

    Please Help

    Thanks[
    Modifier should be used on 992-- codes not on preventive codes.....

    Hope this helps.....

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Depends on the payer. For some if you don't use mod -25 on the preventive they will not pay for the administration codes. We do add -25 to our preventive codes. These codes are in the E/M section of CPT so are technically evaluation and management codes.

  5. Default Thank You
    Thank you both, so now I'm not sure because because one is saying it OK to use and the other is saying no. I'd like more response regarding this issue.

    msmaddy

  6. #6
    Location
    Charleston, South Carolina
    Posts
    641
    Default
    I coded for family practice for years and never used a modifier for E/M and immunications. Never had any problem with any insurance as long as medically necessary.

  7. #7
    Cool Admin w/ CPE
    I agree with Lisa. It depends on your payer. We have seen the admin bundled in with the OV/CPE.

  8. #8
    Default
    we also use -25 on e/m including preventive codes. If you look under the
    imm admin section of CPT, it says " if significant separately identifiable E/M
    service (office, preventive med) the appropriate E/M service code should be
    used in addition to vaccine" that's not a word for word quote. Anyway, the
    ins co I work with have homed in on the "separately significant " part and are
    using it to require -25 on E/M, since mod -25 says "significant,separate".
    At least, that's what the companies tell me.
    Linda,
    Reedsburg,WI

  9. #9
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    I agree with, Lisa, mfc2003 & lfuller - to use the .25 modifier.
    We use the .25 on the E/M's/preventive service when immunizations are given. It is a "separately identifiable" procedure along with the preventive service.
    Donna

  10. Smile thank you
    I thank you all who responded to my question on modifier 25. I think I will start using it and see what happens.

    MsMaddy

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