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Pediatric Coding Alert

You Be the Coder:

Ask This to Determine 25-Service

Published on Fri Apr 03, 2009

Question: At an 11-year-old girls preventive medicine service, a pediatrician learns that the patient has been smoking several cigarettes on a weekly basis for the past several months. The physician explains the ill effects of nicotine to the patient and urges her to stop smoking. The patient shows an interest in changing her behavior. The pediatrician suggests behavioral techniques and schedules a follow-up visit in two weeks. Notes show the pediatrician spent 5 minutes on the smoking cessation counseling. Should I put modifier 25 on 99406 or on 99394? Florida Subscriber Answer: In the case you describe, you should append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of a procedure or other service) to 99406 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes),according to American Academy of Pediatrics coding experts. The patient [...]
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