Wiki Modifier 25

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00032036

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Can anyone tell me if you need to put a modifier 25 on an office visit when you also do labs or an EKG? I was once told these were diagnostic and you didn't need the modifier 25?
 
no need for modifier 25

Modifier 25 is used to indicate a separately identifiable E/M service in the presence of another service. It is used to indicate that you are not unbundling and that the E/M service goes above and beyond the examination/evaluation required by the procedure. Lab and radiology are diagnostic and do not fall into that realm. Here is an article by the OIG regarding use and misuse of modifier 25
http://oig.hhs.gov/oei/reports/oei-07-03-00470.pdf
 
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