Wiki Cardiology Related bundling issues

amym

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Please help!!! We are in desperate need of clarification.

Our doctors perform nuclear stress tests same day and see the patients after the test. If they go over the test results only and go over the patients symptoms, we would bill out an E&M without the modifier -25. If the test is abnormal and he has to order a cath or if he changes medicine for the patient based on the results of the test, we would append a -25 modifier. I have googled looking for information everywhere on the web and have found this statement, "A separate history was taken a separate physical performed, and medical separate decision made" would constitute for adding a -25 modifier. Can someone please shed some light on this for me? Thanks in advance.
 
You will always need a 25 modifier on an E&M code if a stress(93015) is done the same day. I would suggest you read about the NCCI edits. These edits show CPT codes that will be bundled together and require a modifier if billed the same day.
 
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