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Wiki re: E/M and modifier 26

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missykeith

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re: E/M and modifier 26

What distinguishes an additional procedure as "minor"?
 
A minor procedure is one that has 0 or 10 global days. Google: CMS Global Surgical Fact Sheet ICN 907166 February 2012 and read the top of page 2 for additional information.

Not sure what you need to know about mod-26, but mod-26 is only applied to radiology and some medicine codes like an EKG codes, as it refers to the profesional services only such as the interpretation. They should never be applied to an E&M or surgical procedure.
 
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modifier 25

I'm sorry, I meant -25 rather than 26. I'm working on an old issue of coding edge and cannot find the answer I need. It says that modifier 25 may be added to the proper E/M doe to gain payment for an E/M service that occurs on the same day as a minor procedure. What distinguishes a "minor" procedure? options are that the px may be performed outpatient, the px has global pd of less than 90 days, the px is valued at fewer than 3 RVUs, or in at least 80% of cases the px is performed without general anesthetic.
I really apppreciate your help. This isn't what I do, so I just can't come up with the answer!
:confused:
 
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