¶¶Òô´ó¹Ï members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ¶¶Òô´ó¹Ï member’s name and ID number. Only questions will be accepted, not reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.
Question
I have providers who continue to misunderstand modifier 25 and its appropriate use. My providers are providing subsequent visits, and on the same day, they are reading capsule reports. Can you please shed some light on this issue and provide clarification? It is my understanding that the read is bundled into the subsequent visit.
Answer
If the patient is only coming back for the capsule read, the visit is not billed separately. Modifier 25 would be supported only if something unrelated is addressed.