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Shelly Posted Tue 19th of September, 2017 12:17:05 PM
Will you use a modifier 25 on 99214 when you give a injection? Can anyone give me all codes that you would use a modifier 25? or explanation on what you would use it on.
SuperCoder Answered Wed 20th of September, 2017 02:37:53 AM

Hi Shelly,

Yes, 25 modifier would be appended with 99214 when you give an injection.

Modifier-25 is used for an unrelated evaluation and management (E/M) by the same provider or other qualified health care professional that is a significant, separately identifiable services performed on the same day as another procedure or service.

 The physician must show, by documentation in the medical record, that on the day a procedure was performed, the patient’s condition required a separately identifiable E/M service above and beyond the usual care associated with the procedure that was performed. A significant, separately identifiable E/M service is substantiated by documentation that satisfies the relevant criteria for the respective E/M service to be reported.

 

Please check the below links:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/mm5025.pdf

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R954CP.pdf

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/A0180.pdf

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/A0040.PDF

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