modifier 25

pscott

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There are differing views in our office regarding the use of Modifier 25. Some think
you add it to the E&M whenever a test is done, and some think you only use it
when a procedure is done. Medicare requires it when you do an EKG, which is a test, not a procedure. Which is correct?
Thanks!
 

woundokc

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Modifier 25

It is my understanding that a modifier 25 should be added when there something significantly more or something new at the time of the procedure. I don't think it can be related to the procedure itself. If the patient has a new problem, or something additional needs to be done that is unrelated to the procedure, then you can charge an E&M with the 25 modifier.
 
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