# Can I  use modifier 25 with preventive medicine and E/M same date of service



## vikas.maheshwari (Mar 30, 2010)

is 

93985-25
99214-25
10060 

is correct


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## mitchellde (Mar 30, 2010)

Vikas Maheshwari said:


> is
> 
> 93985-25
> 99214-25
> ...



For your scenario you would use the 25 on the 99214 only HOWEVER it is an issue to use a level 4 ov with a preventive, a level 4 is a very intense encounter and as such may indicate the patient is too ill to be subjected to a preventive encounter at this time.  The AMA last year had a memo on their website that suggested the ov should be a level2 when combined with a preventive.  I agree this makes good sense.


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## sparkles1077 (Apr 5, 2010)

Agree with Debra above.  Our state regulations will not pay for an E and M above level 2 when billed with preventative medicine.


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## OCD_coder (May 2, 2010)

Emergency Departments do not use 99214 codes.  This is not appropriate as all patients coming in to the ED are NEW patients.  The visit would entail a workup and NOPP based on all of the problems being treated.
A 99285 are High Risk E/M levels and probably not appropriate for this scenario since there isn't a life-threatening level of workup needed.

DO not use a 99214 in an ER setting - proffessional side or facility.


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## mitchellde (May 2, 2010)

mworcester said:


> Emergency Departments do not use 99214 codes.  This is not appropriate as all patients coming in to the ED are NEW patients.  The visit would entail a workup and NOPP based on all of the problems being treated.
> A 99285 are High Risk E/M levels and probably not appropriate for this scenario since there isn't a life-threatening level of workup needed.
> 
> DO not use a 99214 in an ER setting - proffessional side or facility.



I believe she meant 99385 not 93985 as she was referring to a preventive visit level with an ov level on the same day, not an ER 99285 visit at all.


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