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mod 25 - Can anyone shed some light on this

  1. #1
    Question mod 25 - Can anyone shed some light on this
    Medical Coding Books
    Can anyone shed some light on this , certain ins co wants a 25 mod on CPT 99292. What are your thoughts

    Thanks
    L

  2. #2
    Default
    99292 is an add-on code so you are correctly using it in conjunction with the 99291? If you are doing another procedure tht is separate and identifiable with the E&M then the 25 would be put on the 99291 but not the 99292. Your CPT clearly explains the use of these codes and modifiers. Hope that helped.

  3. #3
    Default mod 25
    The ins co will not pay this service without the 25 mod on the cpt 99292. We do know the the mod 25 is separately identifiable. The ins co will not pay for the additional time if the 25 is not on the cpt code

  4. #4
    Default mod 25
    The ins co will not pay this service without the 25 mod on the cpt 99292. We do know the the mod 25 is separately identifiable. The ins co will not pay for the additional time if the 25 is not on the cpt code

  5. #5
    Default
    Quote Originally Posted by iovine View Post
    The ins co will not pay this service without the 25 mod on the cpt 99292. We do know the the mod 25 is separately identifiable. The ins co will not pay for the additional time if the 25 is not on the cpt code
    If this is what the insurance company requires than I would do it. They may have a claim edit software that does not recognize 99292 as payable without 25. I do not see anything bad in this. Different ins companies may have different rules.

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