tci Medicare Compliance & Reimbursement - 2010 Issue 18

Modifiers: E/M Services Call for Modifier 25, But Only When Necessary

You'll be putting your practice in the crosshairs if you misuse this modifier. Knowing when to append a modifier can be tricky, but many coders will tell you that one of the most misunderstood is modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). If you count yourself in that confused group, use these four criteria to determine whether modifier 25 is right for your next coding assignment. 1. Modifier 25 is for E/M Only You can only consider reporting modifier 25 when coding an...

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