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Does anyone know if you need a modifier on a visit (25) when labs or x-rays are done? It's my understanding that these procedures are diagnostic and it wasn't necessary to add that modifier to the visit. Any help out there? Thanks.
If it is only labs and x-rays, then no -25 modifier is necessary. CT scans and EKG's are a different story. If they have a status of "S", then the -25 is necessary.
If a CPT procedure has been coded along with an E/M (Evaluation and Management) code:
IF the status indicator is S or T and IF this is a significant, separately identifiable E/M service by the same physician on the same day, then modifier -25 should be added to the E/M code.