Are You Using Modifier 25 Accurately?
Published on Thu Aug 27, 2009
Modifier 25 is one of the most misunderstood modifiers. In many cases, it is misused, missing or just plainly misunderstood. To really understand modifier 25, first you have to understand what an E/M code is. For the uninitiated, E/M stands for 'Evaluation and Management;" what was traditionally called an "office visit" or "problem visit." E/M service codes are those codes in the range from 99201-99499. These are the only codes that get modifier 25. "Modifier 25 cannot be looked at in a vacuum; you must understand how it relates to having supporting chart notes, and correct usage with E/M codes," adds Hoda Henein, CHBME, CPL, president and CEO of Active Processing, Inc. in College Point, NY, where she has more than 20 podiatrists on her client roster "Legal, ethical, and moral are all important words in business, and in medicine, but words that are more important are 'policy restriction,'" says [...]
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