Cardiology Coding Alert

In the October 1998 issue of CCA, it was incorrectly indicated that modifier -25 was not to be to be used on consultation codes (99241-99255). Until January 1, 1998, that was true. But not now.

I used to tell my clients that modifiers were not to be used on consultation codes. However, that has changed. Now consultations are considered E/M services, says Don Self, a healthcare consultant in Whitehouse, TX.

He refers readers who want further information regarding the change to these sources: HCFA Carrier Instruction CAR3 15350, dated June 1998, Rev. 1608 and CAR# Transmittal No. 1595 03/98, date March 1998.

Susan Stradley, CPC, CCS-P, senior consultant for Medical Group of Elliott Davis and Co., LLP, headquartered in Greenville, SC, adds that new patient visits can have the modifier -25 attached as well -- if there has been a significant E/M service provided at the time of the procedure. Some would say that this should be obvious, but CPT directs that when a starred procedure is performed at the time of a new patient visit, and the procedure constitutes the major service at that visit, that 99025 is listed in lieu of the usual initial visit code, she explains.

For this reason, a modifier -25 would be necessary to show that a significant, separately identifiable E/M service was performed.

Note: When a star follows a surgical procedure code, the service listed includes only the surgical procedure, not any associated pre- or postoperative services.