tci Part B Insider - 2010 Issue 5

READER QUESTION: Halt Confusion Between Modifiers 25 And 59 With These Quick Tips

Equate modifier 25 with significant and separately identifiable E/M service, and append it to the E/M code only. Question: When appending modifiers with E/M service during a pulmonary function test (PFT), I'm not sure which modifier to add to the pulmonary function code. Is it modifier 25 or modifier 59? Please help. Answer: These two modifiers can really get confusing, but all is not lost. Just focus on the main difference between modifiers 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) and 59 (Distinct procedural...

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