Forum - Questions & Answers

Sep 28th, 2016 - kgabel 2 

Modifier 25 usage

Medicare patient. Admitted with a 99223 and 5 hours later requires critical care which includes an arterial line. What is the proper modifier usage?

Sep 28th, 2016 - rphelps 615  1 

re: Modifier 25 usage

modifier 25

Sep 28th, 2016 - petunia 195 

re: Modifier 25 usage

If a patient is admitted 99223 and later goes critical you can also bill the critical care code 99291 as well as the art line 36620. You would use the 25 on both 99223 and 99291. Your notes should be very clear and support the admission and later going critical.

Sep 29th, 2016 - kgabel 2 

re: Modifier 25 usage

Thank you for the replies. Here is another one.
Medicare patient is admitted with a 99223 and later in the day requires critical care with 99291 and 99292.
How is the 25 modifier used in this instance?
Thank you.

Sep 29th, 2016 - petunia 195 

re: Modifier 25 usage

99223-25
99291-25
99292-25
Is how we submit our cases like that.

Sep 30th, 2016 - kgabel 2 

re: Modifier 25 usage

Thank you for your reply. Can you tell me why you have a 25 on the 99223?



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