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Thread: Modifier 25 question

  1. #1
    Join Date
    Apr 2007

    Default Modifier 25 question

    AAPC: Back to School
    If a patient comes in for a post-op check up and has an injection given in the post-op site, where would you put the mod.25 since 99024 is a zero charge and will not print out on a claim? All input is apprieciated!

  2. #2
    Join Date
    Apr 2007


    you wouldnt use the 25 modifier. Use the appropriate injection code with either the 58/78/79 modifiers as appropriate.

  3. #3
    Join Date
    Apr 2007


    The patient was seen in the office not returning to the operating room nor was it a staged procedure.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default -79 unrelated procedure OR service

    Modifier -79 is for "Unrelated Procedure or Service by the Same Physician During the Postoperative Period"
    If you read the description in Appendix A of CPT there is no mention made of returning to the OR.

    So, if the injection is unrelated, mod -79 would be appropriate.

    F Tessa Bartels, CPC

  5. #5


    don't forget that related services to the original procedure, or determined to be a complication of the original procedure, (within the post-op period) are bundled into the first surgical procedure. You can get more global surgical information on the Medicare Physician's web site under internet manuals, Claims Processing 100-4, chapter 12, section 40 I believe. Or check the NCCI policy manual as well.

    MC: http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

    NCCI: http://www.cms.hhs.gov/NationalCorre....asp#TopOfPage

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