When to Use Modifier 25 and Modifier 57 on Physician Claims

Article Overview

This article reviews the general distinction between two physician-claim modifiers and why the difference matters for E/M reporting and claim review. It is written for coders, auditors, and billing professionals who need a high-level understanding of how documentation, same-day services, and surgical context affect modifier use. The article also notes common situations where one modifier is sometimes applied incorrectly and contrasts broader claim scenarios involving surgery-related decision-making.