g.fairchild
Networker
Hi All...
Just looking for some opinions on use of the 25 modifier. We are a private practice and Medicare was here and did some training, but stated that we should only use the 25 modifier if the E&M was performed for a reason unrelated to the other procedure performed (in most of our cases: a Toradol Injection)....
We scheduled our patient for the E&M because of the narcotics she is on, and to renew her prescription(s)...during the course of the exam, she complained that her pain was higher than usual and requested that we do the injection.
When we billed we did use the 25 modifier on the E&M, which did get paid. But after reviewing their (MCR's) examples...I am more confused now than before on the appropriate use of this modifier.
We had also used an E&M with modifier 25 when refilling pump patients, but can see their point that there is no unrelated E&M for these visits (Although our Pump Manufacturer says to use the E&M with a 25 modifier)...
Any opinions are GREATLY appreciated!!
Signed...MEDICARE GIVES ME A HEADACHE!!
Just looking for some opinions on use of the 25 modifier. We are a private practice and Medicare was here and did some training, but stated that we should only use the 25 modifier if the E&M was performed for a reason unrelated to the other procedure performed (in most of our cases: a Toradol Injection)....
We scheduled our patient for the E&M because of the narcotics she is on, and to renew her prescription(s)...during the course of the exam, she complained that her pain was higher than usual and requested that we do the injection.
When we billed we did use the 25 modifier on the E&M, which did get paid. But after reviewing their (MCR's) examples...I am more confused now than before on the appropriate use of this modifier.
We had also used an E&M with modifier 25 when refilling pump patients, but can see their point that there is no unrelated E&M for these visits (Although our Pump Manufacturer says to use the E&M with a 25 modifier)...
Any opinions are GREATLY appreciated!!
Signed...MEDICARE GIVES ME A HEADACHE!!