Medicare Compliance & Reimbursement - 2017 Issue 6
Modifier Basics: Distinguish 57 and 25 to Avoid E/M Claim Denials
Subscribe or sign in to view the full article.
Article Overview
This coding tutorial focuses on modifier selection for same-day evaluation and management and procedure reporting. It is aimed at coders and billing professionals who need to understand the broad circumstances in which the article discusses major and non-major procedures, global periods, and documentation considerations. The article includes practical guidance, examples, and reminders about when each modifier is discussed in relation to claim denial prevention and reimbursement accuracy.
Why This Topic Matters
Correct modifier selection can affect whether same-day services are recognized appropriately on claims and whether denials are avoided. The article is relevant to professionals who code surgical and office visit services and who need to understand documentation expectations tied to same-day reporting.
Article Sections
-
Identify Modifier Choices
Introduces the two modifiers discussed in the article and frames the general same-day reporting context for evaluation and management services and procedures.
-
Distinguish 57, 25
Discusses the role of global periods and how they are used as a central topic in comparing the two modifiers.
-
Focus 57 Reporting
Covers the modifier 57 discussion, including the documentation emphasis and the article’s illustrative example involving surgery.
-
Watch for ‘25’ Opportunities
Covers the modifier 25 discussion, including the article’s illustrative example and the broader same-day service context.
What You Will Learn
- How the article distinguishes the two modifiers in same-day reporting scenarios
- Why global periods are discussed as part of modifier selection
- What kinds of documentation themes are associated with separate evaluation and management services
- How the article frames examples involving surgery and office or outpatient visits
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Physician practices
- Surgical specialty offices
Codes Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.


Quick, Current, Complete - www.findacode.com