CMS closes modifier 25 loophole in the 2025 NCCI manual

Why This Topic Matters

Annual CMS updates to the NCCI Manual can affect how same-day services, evaluation and management reporting, and procedure-to-procedure edits are reviewed in coding workflows. Staying aware of these changes helps practices align internal coding policies with current federal guidance and avoid outdated assumptions.

Article Sections

1. Modifier 25 when global surgery does not apply

   This section covers revised CMS guidance in the 2025 NCCI Manual concerning evaluation and management services reported on the same date as procedures with a nonapplicable global surgery concept. It also notes related wording changes across manual chapters and the general context for the update.

2. More on mutually exclusive edits

   This section summarizes the manual’s expanded discussion of mutually exclusive edits in the NCCI procedure-to-procedure table. It focuses on the addition of new explanatory language in Chapter 1 and the broader policy area addressed by CMS.

3. Resources

   This section lists supporting CMS reference materials connected to the manual update and related fee schedule information.