03.2023 - Wondering if others can comment . . . there was a lengthy discussion on the application of Modifier 25 on E/M codes WITH Xrays back in 2015. 8 years late - curious if others are seeing / aware of this being standard practice expected from the major payers? Our coding company is stating that most payers DENY xrays without the 25 Modifier on E/M. I am hoping to find or have access to something 'credible' to support this statement. We are an Orthopaedic clinic that regularly OPI xray with visits.
I am recently re-certified (within past 2 years) and NO MENTION of this application of Mod 25 in AAPC training or testing.
Thank you for any references to support this increased use of Mod 25.
Julie Ferkovich
CPC
I am recently re-certified (within past 2 years) and NO MENTION of this application of Mod 25 in AAPC training or testing.
Thank you for any references to support this increased use of Mod 25.
Julie Ferkovich
CPC