Modifier -25 with S or T indicators

katiejeanne

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Regarding ER coding....when coding with our new 3M system I get an edit that says a -25 modifier is needed on the E/M code because a code with an S and/or T indicator is on the visit. Do I automatically put the modifier on? Also, I am doing E/M coding for the facility as well as the physician side. So which E/M level would I put the -25 modifier on? Thanks for any help in advance!!!

Katie:confused:
 

mitchellde

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For facility billing anytime a status S or status T procedure (IV adminisrtration is a status S, Ultrasound is a T, chest xray is an X, laceration repair is an S) is performed in addition to a facility E&M you will need a 25 modifier on all outpatient encounters for that day. As far as the physician is concerned, if he has an assessment and also performs a procedure you will need a 25 modifier.
 
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