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E & M services with modifier 25
Medical staff identified incorrect use of the modifier 25, significant E & M services were not described within medical record documentation.
E & M services on the same date as a surgical procedure are included in the fee for the surgery. If an E & M requires significant effort above and beyond the usual pre- and post-procedure.services the modifier 25 may be appropriate.
Billing of both an E&M and certain procedures on the same day may be
Inappropriate, unless the E&M is rendered for a separate or significantly identifiable diagnosis, medical record documentation must support the medical necessity of the separate E & M procedure.
Medical staff identified incorrect use of the modifier 25, significant E & M services were not described within medical record documentation.
E & M services on the same date as a surgical procedure are included in the fee for the surgery. If an E & M requires significant effort above and beyond the usual pre- and post-procedure.services the modifier 25 may be appropriate.
Billing of both an E&M and certain procedures on the same day may be
Inappropriate, unless the E&M is rendered for a separate or significantly identifiable diagnosis, medical record documentation must support the medical necessity of the separate E & M procedure.
