# Cpx & Immun With Mod 25



## MsMaddy (Jun 13, 2008)

Hello,

I wanted to know if anyone knows if it is ok to use mod 25 to office level
when pt comes in for cpx and get immunization or injections ?

Example

99392-25   prevenative coed
90715- td immun
90471- admin inj

Please Help

Thanks


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## MsMaddy (Jun 13, 2008)

madlen said:


> Hello,
> 
> I wanted to know if anyone knows if it is ok to use mod 25 to office level
> when pt comes in for cpx and get immunization or injections ?
> ...


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## LOVE2CODE (Jun 13, 2008)

madlen said:


> madlen said:
> 
> 
> > Hello,
> ...


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## Lisa Bledsoe (Jun 16, 2008)

Depends on the payer.  For some if you don't use mod -25 on the preventive they will not pay for the administration codes.  We do add -25 to our preventive codes.  These codes are in the E/M section of CPT so are technically evaluation and management codes.


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## MsMaddy (Jun 17, 2008)

*Thank You*

Thank you both, so now I'm not sure because because one is saying it OK to use and the other is saying no.  I'd like more response regarding this issue.

msmaddy


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## mmorningstarcpc (Jun 27, 2008)

I coded for family practice for years and never used a modifier for E/M and immunications.  Never had any problem with any insurance as long as medically necessary.


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## mfn1974 (Jun 27, 2008)

*Admin w/ CPE*

I agree with Lisa.  It depends on your payer.  We have seen the admin bundled in with the OV/CPE.


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## lfuller (Jul 3, 2008)

we also use -25 on e/m including preventive codes. If you look under the
imm admin section of CPT, it says " if significant separately identifiable E/M
service (office, preventive med) the appropriate E/M service code should be
used in addition to vaccine" that's not a word for word quote.  Anyway, the
ins co I work with have homed in on the "separately significant " part and are
using it to require -25 on E/M, since  mod -25 says "significant,separate".
At least, that's what the companies tell me.  
Linda, 
Reedsburg,WI


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## dmaec (Jul 3, 2008)

I agree with, Lisa, mfc2003 & lfuller - to use the .25 modifier.
We use the .25 on the E/M's/preventive service when immunizations are given. It is a "separately identifiable" procedure along with the preventive service.
Donna


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## MsMaddy (Jul 21, 2008)

*thank you*

I thank you all who responded to my question on modifier 25.  I think I will start using it and see what happens. 

MsMaddy


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