Forum - Questions & Answers

May 12th, 2011 - SCOLLINS01

Modifier 25 with pft on office visit scheduled same day

In all instances with established patient having scheduled or unscheduled Pulmonary Function Tests done on same date, do we always append modifier 25 to the E/M to denote that our Pulmonary MD separately had an office visit with the patient?

Are there any instances where the office visit E/M and the PFT would be billed without the 25 modifier?

Your help would be greatly appreciated. We just want to be sure we are billing correctly.

Thanks,

Sheila C.
(Davinshe@juno.com)

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May 12th, 2011 - jschmutz   323 

re: MODIFIER 25 WITH PFT ON OFFICE VISIT SCHEDULED SAME DAY

You would not bill the E/M as well as the PFT when the patient was scheduled for the PFT, unless the patient was also evaluated for a separate problem and that problem was also treated and managed. In that case you would report the E/M with a 25 modifier as well as the PFT.

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