Neurology & Pain Management Coding Alert

Avoid overusing this modifier and soliciting an audit with four tips.If you find yourself especially overwhelmed and confused by modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service), you're not alone. Luckily, you can use these four criteria to determine whether modifier 25 is right for your neurology coding assignment.1. Modifier 25 is for E/M OnlyYou can only consider reporting modifier 25 when coding an E/M service. If the procedures you're reporting don't fall under E/M services, it's possible the encounter qualifies for another modifier instead.How it works: You would use modifier 25 to indicate you have documentation that supports an E/M was significant and separately identifiable from the work included in another service or procedure. By contrast, modifier 59 (Distinct procedural service) can be used only to distinguish one procedure from another procedure.2. Extent of [...]