modifier -25 A code added to CPT coded bills (in the USA) for professional healthcare services that is used to identify a significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. ...
It is important to note that CMS is fully aware that E/M services are billed with intravitreal injections more than 50% of the time. This fact is accounted for in the valuation of CPT code 67028. Given the above, when is it correct to use modifier -25 with an intravitreal injection?
This fact is accounted for in the valuation of CPT code 67028. Given the above, when is it correct to use modifier –25 with an intravitreal injection? The clinical scenarios on the next page provide some clarification. There are two primary factors to consider when determining whether an E...
• When using 25 on an E/M service on the same day as a procedure, the E/M service must have the key elements (history, examination, and medical decision making) welldocumented. NOTE: However, although CPT does not limit this modifier to use only with a specific type of procedure or...
Common Procedural Terminology (CPT) modifier -25 identifies a significant, separately identifiable evaluation and management (E/M) service. It should be used when the E/M service is above and beyond the usual pre- and post- operative work of a procedure with a global fee period performed on ...
Using the data collected in the previous three steps, the correct E/M CPT code can be determined. In Step 1, the patient location and type were identified. These two characteristics gave us the first four digits of the correct code. In Step 2, the level of medical decision making involved...
The Medicare National Correct Coding Initiative (NCCI) includes Procedure-to-Procedure (PTP) edits that define when two Healthcare Common Procedure Coding System (HCPCS)/ Current Procedural Terminology (CPT) codes should not be reported together either in all situations or in most situations. For ...
This modifier may only be submitted with surgery codes. For E/M services performed in the global period of a surgery, refer to CPT® modifiers 24, 25 and 57. An operating room for this purpose is defined as a place of service specifically equipped and staffed for the sole purpose of pe...
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day global period a -25 modifier is used on the E/M. If the procedure discussed has a 90 day global period the -57 modifier would then apply to the E/M.Ex: 20610 = 0 day global Code as: 99213-25, 20610Ex: 27816 = 90 day global Code as: 99213-57, 27816Global...