In Appendix A of the 2008 CPT codebook, the explanatory language of modifier 25, Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service, does not include the term physician in the opening sentence. Can physicians report modifier 25 for an evaluation and management service? ...
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Article Overview
This article covers a CPT Appendix A language change from 2008 and its effect on the use of modifier 25 in relation to evaluation and management services. It is relevant to coders, physicians, and other qualified health care professionals who work with CPT guidance and payment-program-defined E/M reporting. The discussion focuses on the reason for the wording revision and the general applicability of the modifier without reproducing the premium content’s detailed guidance.
Why This Topic Matters
Understanding this CPT wording change helps readers recognize how official explanatory language can affect reporting practices for evaluation and management services and avoid misinterpreting who may use the modifier.
What You Will Learn
- What changed in the 2008 CPT explanatory language for modifier 25
- Why the wording revision matters for reporting evaluation and management services
- Which types of professionals are discussed in connection with the modifier
- How the article frames the relationship between CPT guidance and payment-program definitions
Who Should Read This
- Medical coders
- Physicians
- Other qualified health care professionals
- Billing and reimbursement staff
Modifiers Discussed
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