Properly Billing for Intravitreal Injections with E/M Code 99211-99215 and Modifier 25
Date: March 21, 2025
CMS TPE audits of intravitreal injections and the accompanying office visit continue. Practices involved in these reviews often question what auditors are looking for. These reviews focus on the quality of procedure documentation, the medication and associated office visit, as well as the accuracy of the claims for reimbursement.
On March 21,2025, a new resource to help providers to prepare for TPE reviews was posted on the WPS website (click here). This resource provides helpful information that may eventually be adopted by other MACs around the country. 06
For further information or assistance, please reach out to us at (800) 399-6565 or use our Contact page.
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