tci E/M Coding Alert - 2013 Issue 5

Modifiers: Follow 3 Steps to Solidify Your Modifier 25 Use, Before Your Payers Come Knocking

Don’t confuse 25 and 57; look to the global period. Payers are scrutinizing and denying modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service) more than ever before. If you are attaching 25 to a significant portion of your provider’s E/M codes, you are sending up a red flag. Learn how to identify legitimate opportunities for separately identifiable E/M and procedure coding using modifier 25 with these three guidelines. 1. Ensure Your Provider Performed a Separate Service You...

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