AMA CPT® Assistant - 1992 Issue 4 (Winter)
Modifiers -21, -24, -25 (Winter 1992)
Winter 1992 pages 20-21 Coding Clarification Modifiers -21, -24, -25 In the Fall 1992 issue of the CPT Assistant, we discussed the modifiers generally used with surgical procedures. Modifiers -21, -24, and -25 were not discussed in that issue because of the unique nature of their use to modify procedures associated with a surgical package or surgical procedure. It is important to note that "surgery" is not defined in CPT. Although there is a section of CPT entitled "Surgery," this designation was made to group like procedures together. Some procedures in this section, for example, are "diagnostic" and...
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Article Overview
This Winter 1992 CPT Assistant article covers coding clarification for selected evaluation and management modifiers in the CPT framework. It is aimed at coders, billers, auditors, and clinicians who need a high-level understanding of when these modifiers are discussed in relation to procedures, postoperative periods, and same-day services. The article also references related CPT and ICD-9-CM identifiers while situating the guidance within broader CPT section structure and documentation context.
Why This Topic Matters
Understanding how these modifiers are discussed in relation to evaluation and management services helps readers interpret historical CPT guidance and recognize the type of documentation context the article addresses.
Article Sections
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Coding Clarification
Overview of the article’s clarification focus and the context for discussing selected modifiers within CPT. It introduces how the guidance is organized and why the topic is relevant to different service categories.
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Modifier -21
Discussion of the modifier in relation to prolonged evaluation and management services and its placement within the broader CPT framework. The section includes historical explanation and documentation context.
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Modifier -24
Discussion of the modifier in relation to evaluation and management services during a postoperative period and related claim context. The section uses an example scenario to frame the topic at a broad level.
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Modifier -25
Discussion of the modifier in relation to significant, separately identifiable evaluation and management services on the day of a procedure. The section provides broad context for same-day service reporting and documentation.
What You Will Learn
- How the article frames selected CPT modifiers in relation to evaluation and management services
- How postoperative and same-day service context is discussed at a high level
- How the article situates these modifiers within CPT section structure and documentation expectations
- Which code sets and historical identifiers are referenced in the discussion
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Physicians and clinical documentation staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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