tci ED Coding & Reimbursement Alert - 2003 Issue 3

Fight for Your Modifier -25 Claims with These 4 Simple Suggestions

Who knew that one little modifier could do so much damage for ED coders? But put modifier -25 on your claims, and you'll have payers up in arms. Defend your modifier -25 claims right from the start and avoid those timely denials. The easiest way to report and get paid for modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) is to clean up and clarify these claims before they go out. Here's how.1. Append modifier -25 only to E/M services. Do not use...

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