#LearnOneModifierAtATime
Автор: MedicalCodingWithS
Загружено: 2025-11-30
Просмотров: 135
Описание:
Today, let’s learn about Modifier 25.
Modifier 25 is used when a provider performs a separate and significant evaluation and management service on the same day as a procedure. The E/M service must go above and beyond the usual care required for the procedure.
Ask yourself: Did you document a full E/M visit for a specific problem? Could it be billed on its own? Is there a different diagnosis or extra work beyond the procedure? If yes, Modifier 25 may apply.
Example: A patient comes in for a mole removal. If the visit is only for the procedure, the E/M is included. But if the mole looks suspicious and the doctor evaluates it, discusses risks, and plans further care in a separate session, that portion of the visit is billed with Modifier 25 along with the procedure.
Remember, Modifier 25 ensures that extra work done on the same day as a procedure is properly recognized and reimbursed.
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