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Refraction and modifier 25

  1. Exclamation Refraction and modifier 25
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    When a coding a refraction in addition to an E/M visit on the same DOS, should a 25 modifier be used and a modifier 26 for interpretation of the refraction? 92004-25,92015

    Also, with Fundus Photos is there a modifier needed with the E/M

  2. #2
    Columbia, MO
    I have never used a 25 with these and no 26 as the interp is part of the code. Medicare does not reimburse for the refraction, that is patient responsibility.

    Debra A. Mitchell, MSPH, CPC-H

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