tci ED Coding & Reimbursement Alert - 2023 Issue Q1

Modifier Madness, Part 1: Use Documentation to Master Modifier 25 Usage

Encounter notes could be difference between E/M-25 and no E/M. In the coding world, few modifiers are more commonplace than modifier 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). That ubiquity doesn’t mean using the modifier is easy, however. Why? There are several different interpretations of the descriptor language floating around, which leads to incomplete documentation and misuse of the modifier. For this reason, we’ve prepared this two-part series on modifier 25 and what it means for...

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