Wiki modifier -25

[charonate]

I have a question, My understanding about billing preventive visit with E/M visits and other procedures (e.g. 17000 or 20610) only the E/M needs the modifier -25.. but lately my supervisor has been telling me to add modifier -25 to preventive visits as well because they are bundling with the procedure code.. need help and clarification..

Thank you,
charonate.

 

[missy874]

Your supervisor is correct. The preventive codes 99381-99397 are still considered E/M codes.

 

[charonate]

Thank you..

 

[Peter Davidyock]

Please keep us posted when you receive some EOB's after doing this.
I am really interested in knowing how something like 99213-25/99397-25/17000 pays.
I would think the -25 on the 213 with your dx codes applied accordingly would suffice.