tci E/M Coding Alert - 2016 Issue 11

Modifiers: Go Global to Find Proper E/M Modifier

Trouble deciding between modifiers 57 and 25? Here are the answers you need. When your physician performs a significant, separately identifiable evaluation and management (E/M) service in addition to performing a surgical procedure or other type of service, you might be able to report an E/M code along with the procedure. The rub:In order to code the E/M properly, you’ll have to choose whether to append modifier 57 (Decision for surgery) or 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or...

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