Wiki Injections + when to use 25 modifier

lizzardb

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This topic may be in another post, but I've had trouble finding one to address this:

Scenario #1: If a patient comes into the office, is evaluated for the first time for a new issue(for knee arthritis, for example), and given a steroid injection, is it appropriate to bill the E&M code with a 25 modifier, plus 20610 and the medicine code?

Scenario #2: If that patient comes back in several weeks or months later for the same problem, and is given another injection without being re-evaluated for the arthritis, is it appropriate to bill just the e&m, just the medicine and injection, or both? And if they are re-evaluated, what would be the appropriate codes?

Scenario #3: If a patient comes in for the first time for a new issue(again for knee arthritis), is evaluated and given a Supartz injection that day and scheduled for the subsequent injections, is it appropriate to bill the E&M code with a 25 modifier, plus 20610 and the medicine code? (I know for the subsequent injections, we can only bill the 20610 and medicine code).

Scenario #4: If a patient comes in for the first time for a new issue(again for knee arthritis), is evaluated, and has to return to the office to begin Supartz, can an e&m code be billed with a 25 modifier when he returns to the office to begin?

Any input provided would be greatly appreciated!

Thank you!
 
This topic may be in another post, but I've had trouble finding one to address this:

Scenario #1: If a patient comes into the office, is evaluated for the first time for a new issue(for knee arthritis, for example), and given a steroid injection, is it appropriate to bill the E&M code with a 25 modifier, plus 20610 and the medicine code?

Scenario #2: If that patient comes back in several weeks or months later for the same problem, and is given another injection without being re-evaluated for the arthritis, is it appropriate to bill just the e&m, just the medicine and injection, or both? And if they are re-evaluated, what would be the appropriate codes?

Scenario #3: If a patient comes in for the first time for a new issue(again for knee arthritis), is evaluated and given a Supartz injection that day and scheduled for the subsequent injections, is it appropriate to bill the E&M code with a 25 modifier, plus 20610 and the medicine code? (I know for the subsequent injections, we can only bill the 20610 and medicine code).

Scenario #4: If a patient comes in for the first time for a new issue(again for knee arthritis), is evaluated, and has to return to the office to begin Supartz, can an e&m code be billed with a 25 modifier when he returns to the office to begin?

Any input provided would be greatly appreciated!

Thank you!

#1 = Yes

#2 = I'd go with injection only

#3 = Yes

#4 = No
 
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