Yes, you can add modifier 25 to code 99395. Modifier 25 indicates that a significant, separately identifiable evaluation and management service was performed on the same day as another service. In this case, it would suggest that a comprehensive preventive exam (99395) was conducted alongside an additional evaluation or treatment that warranted separate billing.
FALSE
No, you cannot report modifier 25 and modifier 52 on the same clinic visit. Modifier 25 indicates a significant, separately identifiable E/M service performed on the same day as another service, while modifier 52 is used to indicate a reduced service. Since they serve different purposes and imply different levels of service, using them together would not be appropriate in a single visit.
Modifier -51 is used in coding to indicate that multiple procedures were performed during the same session. For the code 51797, which refers to a specific procedure related to the urinary system, you would add modifier -51 if you are reporting multiple procedures and the payer requires it to indicate that the primary procedure is being billed alongside additional ones. However, if 51797 is the only procedure being billed, then modifier -51 is not necessary. Always check with the payer’s guidelines for specific requirements.
.25 x 60,000 = 15,000 add to get 75,000
example modifier and complement
no
The modifier commonly used with add-on codes is Modifier 51. This modifier indicates that multiple procedures are being performed during the same session, with one primary procedure and additional secondary procedures identified by the add-on codes. However, it's important to note that add-on codes themselves should not be reported with Modifier 51, as they are inherently understood to be additional procedures. Instead, the primary procedure should be marked with Modifier 51 if necessary.
Yes, however add 99203 modifier 25.
25
FALSE
Add on Codes Can not be billed with Modifier 51(multiple Procedures).
No, you cannot report modifier 25 and modifier 52 on the same clinic visit. Modifier 25 indicates a significant, separately identifiable E/M service performed on the same day as another service, while modifier 52 is used to indicate a reduced service. Since they serve different purposes and imply different levels of service, using them together would not be appropriate in a single visit.
25
99395
Modifier 25 is used to indicate that a significant, separately identifiable evaluation and management (E/M) service was provided on the same day as a procedure. If you are billing for a 99233 (an E/M service) along with 93306 (an echocardiogram), you would append modifier 25 to 99233 only if the E/M service was distinct and not part of the procedure. Make sure to document the medical necessity for both services clearly to support the use of modifier 25.
The 25 modifier is typically added to the evaluation and management (E/M) service code that is billed separately when a procedure or service is performed on the same day. In this case, if both 99283 (Emergency department visit, low to moderate severity) and 99213 (Office or other outpatient visit, established patient) are billed, the 25 modifier is generally added to the code that represents the more comprehensive service. If both codes are necessary, ensure that the documentation supports the medical necessity for each service.
add-on