Wiki Modifiers - preventive med office

[DEBBIE GERDES]

I have a preventive med office visit (99393), a vaccine administration (90471) and a lesion destruction (17110). What modifiers are used and where?

 

[MarcusM]

My opinion is:

99393-57 Dx V20.2
90471 Dx V20.2 (what vaccine was administered, and do you bill for this?)
17110 for whatever separate diagnosis caused the need for destruction of lesions.

Modifier 57: Decision for Surgery
An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service.To report a separate and distinct E/M service with a non-E/M service performed on the same date, see modifier 25.

 

[espressoguy]

I would disagree with the modifier 57. 17110 is a minor procedure with a 10 day global, so I believe modifier 25 would be more appropriate.

 

[Starr5052]

I agree with Mark the espressoguy, Mod 25 all the way. Also you do need to report the vaccination administered along with your admin code.

Ronald G Weightman, CPC
Hospital Coder
Seattle Ultrasound and Radiology
Seattle, WA

 

[OCD_coder]

Starr and espressoguy are correct, because the procedures are 10 day globals or less, the modifier 25 is correct when appended to the E&M service. Here are the instructions:

http://www.cms.gov/Outreach-and-Edu...oducts/downloads/GloballSurgery-ICN907166.pdf

 

[MarcusM]

My thinking was the purpose of the visit was WCC with vaccinations and mom most likely asked if the doctor could do something about the warts, and the doctor froze the warts.