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25 Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified...
CPT® Code Modifiers
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: It may be necessary to indicate that on the day a procedure or service identified by a CPT code was performed, the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. A significant, separately identifiable E/M service is defined or substantiated by documentation that satisfies the relevant criteria for the respective E/M service to be reported (see Evaluation and Management Services Guidelines for instructions on determining level of E/M service). The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such, different diagnoses are not required for reporting of the E/M services on the same date. This circumstance may be reported by adding modifier 25 to the appropriate level of E/M service. Note: This modifier is not used to report an E/M service that resulted in a decision to perform surgery. See modifier 57 For significant, separately identifiable non-E/M services, see modifier 59.
The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
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The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
Additional Code Information
Additional Code Information includes:
APC Status Indicator
Assistant Surgeon (80, 82)
Bilateral Surgery (50)
CCS Clinical Classification
Co-Surgeons (62)
Diagnostic Imaging Family
Facility MUEs
Global Days
Hierarchical Condition Categories (HCC)
Major Complications or Comorbidities (MCC/CC)
Medicare Status Code
Multiple Procedures (51)
Non-Facility MUEs
OTS Orthotic
PC/TC Indicator (26)
Physician Supervisions
Team Surgery (66)
Type Of Service (TOS)
and more...
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Code History
View historical information about the code including when it was added, changed, deleted, etc.
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