Wiki Modifier 25 help please

[TLC]

Now I'm confused. I have ALWAYS been taught if the provider is billing for eg: and 99213 and 92552 (hearing test for hearing problem). I should add a mod 25 to the 99213. Basically anytime there is a procedure or "service" being done we should add a modifier 25 with the exception of 8xxxx codes (lab type codes). Now I'm being told that everything I had be told in the past is wrong. Can someone help me please!!!
Thank you

 

[dalanicks@aol.com]

you do not need a modifier 25, modifier 25 is primarily is used when a procedure that has a 10 day post op see below,

It may be necessary to indicate that on the day a procedure or service identified by a CPT code was performed, the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. A significant, separately identifiable E/M service is defined or substantiated by documentation that satisfies the relevant criteria for the respective E/M service to be reported (see Evaluation and Management Services Guidelines for instructions on determining level of E/M service). The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such, different diagnoses are not required for reporting of the E/M services on the same date. This circumstance may be reported by adding modifier 25 to the appropriate level of E/M service.

 

[TLC]

Thank you for your help!