Anthem rolls out modifier 25 policy that could deny same-diagnosis E/M claims

Article Overview

This premium article covers Anthem’s new modifier 25 policy, how it may affect evaluation and management claims tied to recent or related services, and why coding professionals and medical organizations are raising concerns. It is relevant to billers, coders, compliance staff, and practice managers who handle E/M claims, diagnosis linking, and payer policy changes across Anthem’s operating states. The article also summarizes comments from coding authorities, references CPT guidance, and describes the operational impact for practices as the policy rolls out.