# 93005 and 93017 w/mod 25?



## mollie (May 20, 2008)

We've run into quite some debate on this particular subject.  So the question is since 93005 is a component of 93017 but the results of the EKG is what prompted the treadmill later can/should these be billed with a modifier 25? 

Thanks,
Mollie


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## thompsonsyl (May 20, 2008)

Hi,

I don't believe that modifier 25 can be utilized on codes other than those considered e/m.  Also, according to cci, 93005 is a component of 93017 w/ an indicator of (1).  This would mean that in order to unbundle the two, you would append a (59) modifier to the 93005.

Hope this info helps & Good Luck!


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## mollie (May 21, 2008)

oops, my bad...I meant modifier 59.  We are utilizing the 59 for this scenario but are being told by an outside consultant we are overusing this modifier.  I feel it is entirely appropriate for this scenario though.  Any thoughts?


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## thompsonsyl (May 21, 2008)

Hi,

I think that overall there probably is a high use of the (-59) modifier.  When there has been a question as to when to unbundle procedures, I've gone right to my physician(s).  Ask him if there is justified reason for unbundling the two procedures - show him the description of the (-59) modifier out of the cpt book and give him your scenario.  I've worked with physicians who, after reviewing a coding scenario and the use of various "unbundling" modifiers (-25, -57, -59) have stated that it would not be appropriate to bill w/ them.  Would this work in your situation?


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