Wiki E&M w/labs question

[Pam Baker]

I have not done family practice coding for about 10 years (since have been doing orthopedics w/no labs). I am helping out a family practice clinic and wanted refresh my memory as to whether to use a modifier 25 on the E&M code if also billing a venipuncture, UA, or any other form of labs. Please help my memory. Don't remember having to do that with labs 10 years ago!!

 

[amartin8]

Not usually

You do not usually have to append a modifier 25 to the office visit when performing labs at an office visit. Aetna is the only plan I know of that will only pay for a UA when modifier 25 is appended to the E/M. Most others do not require it though! Hope that helps!
Allyson Martin, CPC, CMC

 

[Pam Baker]

Thanks for the heads up. They were telling me at their office that you do and I thought it sounded a little odd, not quite what I remembered, but it has been a while. Appreciate the answer and help!!