DecisionHealth, DecisionHealth - 2020 Issue 3 (March)

Mind your modifiers: Heed payer-specific guidelines to avoid denials when using modifier 25

Steer clear of common obstacles that can derail your use of modifier 25 (Significant, separately identifiable E/M service) and leave you with yawning gaps in revenue. When applying this modifier, coders must consider CPT¨ reporting rules and adhere to potentially restrictive billing rules followed by their payers.

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