tci Part B Insider - 2014 Issue 4

Modifiers: Use These Straight-From-the-Source Examples of Modifier 25 Rules

These scenarios show you when to use modifier 25—and when to avoid it. We’ve all heard anecdotal evidence about how to appropriately use modifier 25 and when it should be avoided, but in many cases, the information we hear from an office manager can differ from the advice we hear at a coding seminar. But there’s one surefire way to quell that coding confusion—simply go back to the original guidelines when determining when to use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the...

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