kiku3@ptd.net
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I am going to repost a statement someone posted back in August because I believe a correct answer as to whether or not this is a valid statement would help a lot of people understand this Modifier:
"If the service (CPT code) was DIAGNOSTIC (required for the physical exam and or MDM of the CC), then NO modifier 25 is needd on the E/M code. If the service (CPT code) was actually TREATING the condition diagnosed, then modifier 25 is neeed on the E/M code"
here is my example of a recent claim from a doctor: Doc. billed a 99213,25 dx of 38870 (otalgia unspecified) with a 92567 (tympanometry, impedance testing). I do not believe that there should be a modifier 25 used. Opinions, please.
"If the service (CPT code) was DIAGNOSTIC (required for the physical exam and or MDM of the CC), then NO modifier 25 is needd on the E/M code. If the service (CPT code) was actually TREATING the condition diagnosed, then modifier 25 is neeed on the E/M code"
here is my example of a recent claim from a doctor: Doc. billed a 99213,25 dx of 38870 (otalgia unspecified) with a 92567 (tympanometry, impedance testing). I do not believe that there should be a modifier 25 used. Opinions, please.