DecisionHealth, DecisionHealth - 2026 Issue 6 (June)

As modifier 25 audits pick up, key in on internal review, provider education

The Office of the Inspector General (OIG) announced it is launching a new audit of E/M services billed on the same day as minor procedures effective March 16, 2026. When an E/M service that is significant, separately identifiable, and well documented in the clinical record is performed on the same day as a minor surgical procedure, modifier 25 is used to report the E/M service.

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