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Wiki Modifier -25 for Facility Coding of ED E/M

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jnwhite80

jnwhite80

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Hello,

I have been instructed to use a modifier -25 on every ED E/M code when coding for the facility. Mind you I am coding for the facility not billing for the facility.

There was no reason provided regarding this "rule". I could not find anything about this in the CPT manual. I understand the need for a modifier -25 on the ED E/M code when additional services and/or procedures are performed such as a repair of a laceration. What I don't understand is why a modifier -25 would be used when labs or imaging studies are ordered. Aren't those processed through the CDM?

If a source could be provided in your reply that would be greatly appreciated.

Thank you in advance,

Janice N White, RHIA, CPC, CTR
 
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