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tci ED Coding & Reimbursement Alert - 2004 Issue 4

Think You Know How to Use Modifier -25?

Answer 3 questions to tell for sureIf you want to recoup reimbursement for your modifier -25 claims, make sure you can separately identify your ED physician's E/M services from other procedures he performs for the same patient on the same day. Here are three easy questions to ask yourself -- with answers from the experts -- to help guide you on the road to hassle-free use of modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). 1. Does your E/M service stand alone? CMS...

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