tci Part B Insider - 2012 Issue 9

Modifier 25: Conditions for Use

When appending modifier 25, the E/M service must meet these requirements:The E/M is significant and separately identifiable from any "inherent" small E/M component that you should consider part of the minor services/procedures you report on the same day.The E/M may be related or unrelated to other procedures/services you report on the same day.The E/M may be for a totally unrelated reason, orThe E/M may be for the same reason the service/procedure is being performed, but the service/procedure was not pre planned and the it was determined to perform the service/procedure as part of the E/M The service/procedure...

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