tci Part B Insider - 2004 Issue 7

Part B Coding Coach: 4 Questions to Ask Yourself About Modifier -25

If you want to recoup reimbursement for your modifier -25 claims, make sure that you can separately identify your physician's E/M services from other procedures he or she performed for the same patient on the same day. Here are four easy questions to ask yourself - with answers from the experts - to help guide you on the road to hassle-free use of modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). 1. Does your E/M service stand alone? CMS specifies that all procedures have...

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