Wiki 99183 and E/M

[kfrycpc]

Hi all,

I code for a wound care center and often use 99183 (Physician attendance and supervision of hyperbaric oxygen therapy, per session). Sometimes the patient will come in just for this service, and other times there will be an office visit the same day. I noticed that Medicare does not seem to be paying correctly. Still trying to figure out why but I am wondering this:

If an office visit occurs on the same day as the 99183, there should be a modifier (25) on the office visit line, correct?

The problem is....The doctor often lists the office visit and 99183 on SEPARATE fee sheets and I don't get them at the same time so I am unaware both services have been on the same day. When this happens, and there only appears to be an office visit OR a 99183, I don't use a modifier as I am unaware that both have occurred as I've mentioned above. Could this be why the payment is lower???

Thanks, Kellie

 

[ElaineM]

I also do wound care billing. That is odd that the services do not show up on the same superbill...
You can definitely add a separate E/M, if for example the wound is examined and evaluated separate from the supervision of HBO, adding your modifier 25. Are you stating that the HBO payments are not always the same from Medicare?

Elaine

 

[kfrycpc]

I also do wound care billing. That is odd that the services do not show up on the same superbill...
You can definitely add a separate E/M, if for example the wound is examined and evaluated separate from the supervision of HBO, adding your modifier 25. Are you stating that the HBO payments are not always the same from Medicare?

Elaine

I'm not sure why the dr doesn't put them on the same bill.

So I would put a 25 mod on the office visit line?

Yes, the payments are not the same from Medicare.

 

[ElaineM]

Yes, the modifier 25 is appended to the E/M code.
Medicare should be paying the allowable consistently - even when there is an E/M with the HBO supervision. I would call and question them about this.

Elaine