Wiki Supporting 25 modifier

[shariq84]

Does the change in medication due to an exacerbation in symptoms is sufficient to support 25 modifier, ?
few payers do not allow it?

Can anyone suggets?

 

[twizzle]

Does the change in medication due to an exacerbation in symptoms is sufficient to support 25 modifier, ?
few payers do not allow it?

Can anyone suggets?

A change in medication and exacerbation of symptoms are part of the medical decision making affecting the E&M code, so what other CPT code would you bill to justify a 25 on the E&M? There is nothing separately identifiable.

 

[shariq84]

Continued 25 modifier.

Thanks a lot: So does that mean, in case of a preventive care service billed with E/M (established visit), in case the physician prescribes some additional medication due to increased migraine (for example), will still get only preventive service paid and E/M service unbundled??