modifier -25

Do I need a modifier -25 on an E/M service if also done with a pulse ox?

no

cause no one pays for pulse ox- you may jeopardize your payment for the office visit by billing the pulse ox- the insurer may pay the pulse ox and write off the visit!

pulse oximetry, E/M and modifier 25

Medicare bundles pulse oximetry into the payment for all E/M services. Most payers do as well.

There are a few commercial payers who still pay a few dollars for it, but they are few and far between. Using the modifier won't get you paid, however, if the payer has an edit in which bundles the pulse ox into the E/M. And, as signaturedoc says, some will pay you the LOWEST of the amounts billed, and pay you for the pulse ox instead of the o.v. You have to watch for that.