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Modifiers

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Interestingly, my clearinghouse support people tell me that almost

none of their customers use modifiers. Is that true for folks here?

Even if you don't bill preventive/acute, how else to bill a procedure

on the same day, etc.?

Haresch

>

> > To the group,

> > My biller opined today that she feels that we have been very lucky to

> > be getting paid for both a preventive health visit and a problem-

> > oriented E/M service, such as when a patient comes in for a physical

> > and also complains of a significant problem, such as dizziness or

> > joint pain or abdominal pain, etc. I was under the impression that

> > most insurers honor the modifier -25 code and will pay for both E/M

> > services but she thinks that most physicians will not bother

> > submitting the dual codes and when they do, only one of them gets

> > paid. So my two questions to the group are:

> >

> > 1. How often do you submit a claim that has both a preventive health

> > visit PLUS a problem-oriented E/M visit?

> > 2. How often to you get paid for both E/M charges?

> >

> > Seto

> > South Pasadena, CA

> >

> >

>

>

>

> --

> Annie Skaggs

> Lexington, KY

>

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