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Wiki E&M plus Radiology on same DOS

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shellysk8

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Hi,

I am doing an audit on modifier 25 use and came across a finding that the PCP is adding modifier 25 to the E&M when x-rays are done the same DOS. I have been told that it was due to them both billing under the same TIN. I always believed that the modifier is only needed (per CCI) if the service is by the same TIN AND Specialty. I would appreciate any feedback, as we definitely don't want to bill with an unnecessary 25 modifier.

TIA,
Shelly L. Kubacki, BS, MPA, CPC, CPMA
 
Hi,
yes , even i have seen this been followed by some of the providers that they add 25 modifier with an U.S or xray of abdomen.
But as per the coding logic 25 mod is added only to E&M if only an significantly seperately idnetifiable E&M is performed along with an procedure.
 
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