Wiki Wellness Exams and Physicals - Modifier 25 Use?

[SymphonySamantha88]

Hi, if a patient is here for a preventative exam (99396) and there are other procedures done such as injections or EKG, is it appropriate to attach modifier 25 to the exam? Wondering if this applies to Annual Wellness Exams, Complete Physical Exams, etc. Thanks in advance!

 

[cdr4life]

Hello,

Yes, I beleive it would be necessary for you to add the modifier 25 to the E/M code. I code Physicals all the time and i use modifier 25 all the time. If you work with different insurance companies, i strongly recommend you make an Excel spread sheet "cheat sheet" of what insurance companies require for different procedures.

 

[SymphonySamantha88]

Thank you so much for your help smoogie! I have always used it with 99201-99205 and 99211-99215 but didn't know if it was also used with physicals/wellness exams. I really appreciate it!