I was told yesterday by a fellow CPC that I can't use a 25 modifier on an E&M code if the other CPT being billed is NOT in the surgery category codes. In other words if the "other" CPT code is an ultrasound, spirometry, etc. I shoud NOT use the 25 modifier - even when the office note supports it. (that is the only time I am using it) I have been using it on my E&M codes when we do ultrasounds because the patient presents for one problem which leads to another and the secondary reason is why the U/S is performed. These ARE getting paid. Now I am confused!! Thanks!