Wiki preventive service with 25 mod.

[abhishekrane32@yahoo.com]

in office, patient comes with CC of well women exam , no any other complaint.

during physical examination physician finds a lump in the breast. physician orders US for breast lump.

can i code both preventive and office visit code with 25 modifier :confused

if yes i have one more question related to appending modifier 25, can mod 25 append to either preventive cpt or office visit cpt, is there any specific guideline.

ABHISHEK RANE CPC

 

[mboden]

This would become an office visit only without a modifier.

 

[mitchellde]

my suggestion would be to bill as a visit level met by the total of the documentation and append the 33 modifier to indicate a preventive encounter that contains a diagnostic component. By doing this the patient will owe no copay or deductible and it will count as their annual.

 

[amitkumar_s]

You should have to code only CPE cpt as pt does not have complaint of breast lump and intent for visit is only CPE but Dr. incidently find breast lump in physical examination .If pt is coming for both CPE and breast lump then he has prescribe medicine to code addtional ENM with CPE .In simple terms for ordering US or lab he does not have to do effort ,he will simply write and order but for prescribing medicine he has to check everything .