AMA CPT® Assistant - 2012 Issue 3 (March)

Modifiers 25 and 59 (March 2012)

March 2012 pages 4-7 Modifiers 25 and 59 The two-digit code modifiers, listed in Appendix A of the CPT codebook, are provided to indicate that special circumstances may apply to the reported service(s) or procedure(s). This article will discuss the appropriate use of modifier 25, Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service, appended to Evaluation and Management (E/M) services, and the appropriate use of modifier 59, Distinct Procedural Service, appended to other procedural services described in the CPT codebook. This article will further provide examples...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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