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Prolonged service w/modifier -25?

  1. #1
    Question Prolonged service w/modifier -25?
    Medical Coding Books
    When (if ever) would it be appropriate to add a -25 modifier to CPT 99356?

    We bill 99223-25, 96450, 99356 and 99357. I am wondering if a -25 would be appropriate on 99356?


  2. #2
    Columbia, MO
    What you have described here with your codes is an initial hospital encounter as either the admitting or consulting provider that is face to face with the patient and relevant floor time documented as 145 minutes minimum. This cannot include the infusion time nor the time for the spinal puncture which must have a separate procedure note. I cannot answer the question on the modifier until I see the note.

    Debra A. Mitchell, MSPH, CPC-H

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