AMA CPT® Assistant - 1993 Issue 4 (Winter)
Modifiers -21, -25, -57, -58 (Winter 1993)
Winter 1993 page 26-end Coding Clarification Modifiers -21, -25, -57, -58 Modifiers -21, and -25 were revised in CPT 1994. Modifiers -57 and -58 were added to CPT 1994. Modifier -21 -21 Prolonged Evaluation and Management Service: When the face-to-face or floor/unit service(s) provided is prolonged or otherwise greater than that usually required for the highest level of evaluation and management service within a given category, it may be identified by adding modifier "-21" to the evaluation and management code number or by use of the separate five digit modifier code 09921. A report may also be appropriate. Modifier -21...
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Article Overview
This CPT Assistant article explains the 1994-era revisions and additions involving several modifiers used with evaluation and management and surgical services. It is aimed at coding professionals who need to understand the scope of the guidance, the contexts in which the modifiers are discussed, and the general topics covered by the clarification examples.
Why This Topic Matters
The article helps readers recognize how these CPT modifier changes fit into coding for office, outpatient, consultation, surgical decision-making, and postoperative service situations. It is relevant for coders, auditors, and billers who work with CPT guidance and need to compare modifier concepts discussed in this issue with related prolonged service and postoperative reporting topics.
Article Sections
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Coding Clarification
Introductory discussion of the modifier clarification topic and the changes referenced in this issue.
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Modifier -21
Discussion of the modifier update as it relates to evaluation and management services and prolonged service concepts.
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Modifier -25
Overview of same-day evaluation and management reporting in relation to a procedure and the revision noted in the article.
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Modifier -57
Discussion of evaluation and management services associated with a surgical decision and the related CPT update.
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Modifier -58
Explanation of postoperative staged or related services and the circumstances addressed by the modifier update.
What You Will Learn
- How the article frames CPT modifier clarification topics from the Winter 1993 issue.
- Which service categories are discussed in connection with the modifier revisions and additions.
- How the article organizes guidance around evaluation and management and postoperative surgical scenarios.
- What general types of examples are used to illustrate the modifier topics covered in the issue.
Who Should Read This
- Medical coders
- Billing staff
- Coding auditors
- Compliance professionals
- Physician practice staff
Codes Discussed
Modifiers Discussed
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