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Modifers

DeShannon Posted Wed 26th of October, 2016 11:28:22 AM
I am charging a fee ticket for an office visit, allergy testing, and spirometry. Usually my visit just consist of the office visit and allergy testing. I use modifier -25 with the E & M code to indicate it is a separately identifiable service using an appropriate diagnosis code. In this case, I am performing two procedures, the allergy test and spirometry. My question is how and what appropriate modifiers should I use to ensure the E & M code, the allergy testing code and the spirometry code are accepted by the payers? The claim reads as such: 99214 (with modifier 25) 95004 (allergy testing) 94010 (spirometry) or 94060 (Pre and Post spirometry)
SuperCoder Answered Thu 27th of October, 2016 05:19:00 AM

You need not to append any modifier with the allergy testing and spirometry code. You should append 25 modifier with the evaluation and management code to suggest that evaluation and management was performed of a problem other than the current condition for which tests had been ordered. Problem should be significiantly different and unrelated to the current problem.   

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