Policy Manual, chapter one, also addresses that minor surgical procedures include the decision for surgery E/M service; E/M of a second, unrelated problem would be eligible for consideration of modifier 25. Summary for Use of Modifier –25 in Association with Hospital Outpatient Services · Modif...
If a claim is denied, it’s essential to review the documentation and appeal the decision, ensuring that the E/M service is clearly documented as significant and separately identifiable.
Note that Modifier 25 is not used to report an E/M service that resulted in a decision to perform surgery, you might use Modifier 57. For significant, separately identifiable non-E/M services on the same day, you might use Modifier 59. Coding Guidelines for Modifier 25 Modifier 25 can be...