tci ED Coding & Reimbursement Alert - 2000 Issue 9

Overcome the Challenges of Using -25 for ED Services

By Caral Edelberg, CPC, CCS-PPresident, Medical Management Resources Inc.Emergency department (ED) coders confusion about the proper use of modifier -25 demonstrates the need for the Health Care Financing Administration (HCFA) to release its promised guidance on accurate application of this critically important modifier. In the interim, a review of the past information provided by the American Medical Association (AMA) and used by professional component coders, as well as guidance offered by HCFA through the APC implementation process, may help those faced with coding for outpatient services muddle through the modifier process. With implementation of APCs, the HCFA edits...

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