Wiki coding PFTs with an office visit

[jjenelds]

I've been having trouble coding PFTs with an office viist since the beginning of the year. We have Athena for EMR and I'm beginning to think it is a problem with them, but it says a modifier is required, which I have never had to put on before. Does anyone work in pulmonary/sleep that could help me out here? Any info would be greatly appreciated.

 

[rhondareeney]

NCCI edits are wreaking havoc! We use a modifier 25 on the E/M code and also bill the PFT. Insurance bundles the codes together and pays the PFT, forcing us to appeal every single E/M visit! It is a hassle but we almost always get paid on appeal.