# 99395 with modifier 25



## heatherwinters (Jun 3, 2008)

If you bill a preventative medicine code (99395) and you did an immunization Tdap and administration, do you bill a modifier 25 on the 99395.  I thought that modifier 25 was only for use on 99201-99357.  Thanks


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## Lisa Bledsoe (Jun 3, 2008)

Although one would not expect to need a modifier -25 on a preventive code, it seems that more payers are requiring it or the ancillary services won't get paid - like the immunizations.  As coders, we are taught not to slap a modifier on everything, but payers won't pay if we don't.  Quite a conundrum.


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## LOVE2CODE (Jun 3, 2008)

heatherwinters said:


> If you bill a preventative medicine code (99395) and you did an immunization Tdap and administration, do you bill a modifier 25 on the 99395.  I thought that modifier 25 was only for use on 99201-99357.  Thanks




The answer is no....You would use modifier 25 on 99201-99357 if use on the same visit as the preventive code....


YTH, CPC


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## EARREYGUE (Jun 4, 2008)

I would not use it, unless the claim comes back requesting a modifier, we  were using mod.25 for a while on well checks with vaccines and were told we are over using mod.25 by our compliance dept.
E.A.  C.P.C.


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## LOVETAMBRA (Apr 25, 2010)

*Modifier 25*

I have a patient who came in for a well woman and IUD removal, should I use the 25 modifier on the 99395?


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