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Thread: 25 modifier w/ov, new pt.

  1. #71


    AAPC: Back to School
    my question is, if a new patient comes into an urgent care facility and has an i&d 10061, can you also bill an office visit with a modifer 25?

  2. #72
    Join Date
    Apr 2007
    Tyler, Texas


    Whether or not you need the -25 for a new patient may vary by payer, but it would not be incorrect to expect to be paid for BOTH a new patient E&M and a procedure done on the same day, like an I&D. Check your payer rules to determine if the -25 is needed. If the provider had to take some history, determine med allergies and past health issues as part of the evaluation for the condition requiring the procedure, then clearly and E&M service was performed and should be appropriately coded and submitted for reimbursement.

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