RABBIT2020
Networker
As a general rule at my place of coding the modifier 25 must be appended to all Evaluation and Management cpt i.e for office vist 99202-99215; 99241-99245; 99221-99233 for commercial insurance billing.
If there is an evaluation and management following a procedures of 90days or 10 days global the modifiers have to be appended 25, 24.
If there is an evaluation and management with decision for surgery 0-90days global the modfiers have to be appended 25, 57.
There are no exceptions for the the modifier 25 regardless if it is the single only service of the day.
I was told it was to avoid rejections from the payer.
Is this a preventative practice at your place of billing and coding?
If there is an evaluation and management following a procedures of 90days or 10 days global the modifiers have to be appended 25, 24.
If there is an evaluation and management with decision for surgery 0-90days global the modfiers have to be appended 25, 57.
There are no exceptions for the the modifier 25 regardless if it is the single only service of the day.
I was told it was to avoid rejections from the payer.
Is this a preventative practice at your place of billing and coding?