tci Part B Insider - 2012 Issue 9

Modifiers: Master These 3 Modifier 25 Issues to Get Claims Paid

Hint: Modifier 25 may apply to E/M performed with xxx global-day procedures.Want to collect for both a procedure and an E/M service? Then modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) must be your friend. However, practices need to know how to use this modifier properly, or the MAC could ask for a refund. You can prevent paybacks by avoiding the following three problems that will land your claims on the MAC's hot list.Problem 1: No Separate E/M HEM You not only...

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