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tci E/M Coding Alert - 2022 Issue Q1

Reader Questions: Know What Updates Mean for Modifier 25 Usage

Question: Have the modifier 25 rules changed now that the E/M guidelines are different? My co-worker says they have, I thought they hadn’t. New Mexico Subscriber Answer: The rules around modifier 25 haven’t changed, but in some ways, the way you apply this modifier are different than they were in the past. Flash back to five years ago: You wanted to append modifier 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 other service) to an E/M code to demonstrate...

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