tci Medicare Compliance & Reimbursement - 2008 Issue 30

Coding Coach: Clear Up Your Modifer 25 E/M Confusion

Keep E/M documentation apart to demonstrate the service's 'separate' status To report an E/M service that prompts a follow-up procedure, you must append either modifier 25 or modifier 57 to the appropriate E/M service code. Which modifier you select, however, depends not only on the nature of the E/M service but also on the length of the global period associated with the follow-up procedure. Here are the facts you'll need to make the choice easy. Extra motivation: The Office of Inspector General (OIG) has targeted "services within the global period" -- including E/M services with modifiers 25 or 57...

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