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Modifier 25 for Surgical Procedures

Sandra Posted Tue 26th of March, 2013 15:08:12 PM

If we have a patient in for a well care check and then also find that there is a new presenting problem, we code for the well care check E/M with a 993xx and then the new probelm with an E/M with a 992xx with the modifier 25 on the 992xx. We have found supporting documentation for this approach.

Recently we had a patient that had cryosurgery (wart removal) at the same time as the well care check. We were denied for both E/M, even though we put the modifier 25 on the 992xx but the insurance wanted us to also put it on the 993xx. We complied but could not find any documentation that supported their request.

Could you point us to the documentation that would support the insurance company request.

Thank you.

SuperCoder Answered Mon 01st of April, 2013 21:14:49 PM


This query is with our editor. She is working on this and will reply soon. Thanks for being patient. We want to be/get sure for your answer.

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