AHA Coding Clinic® for HCPCS - 2013 Issue 3; For Your Information

Evaluation and management (E/M) services

The Centers for Medicare & Medicaid Services (CMS) recently published guidance regarding the reporting of pulmonary diagnostic procedures and evaluation and management services to Medicare beneficiaries. CMS stated that Modifier 25, Significant, separately identifiable evaluation and management service by the same physician (or same qualified nonphysician practitioner) on the same day of the procedure or other service, should be appended to the evaluation and management (E/M) code when a patient receives separate E/M services in addition to pulmonary diagnostic, therapeutic, or monitoring procedures on the same day by the same physician. Appending Modifier 25 will identify that the E/M...

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