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Thread: Modifier 25 with diagnostic services

  1. #1
    Join Date
    Apr 2007
    Rome, Georgia Chapter - Rome Coding Professionals

    Default Modifier 25 with diagnostic services

    AAPC: Back to School
    I am trying to find something "in writing" where a modifier 25 is not appended to the E/M if the only other service is a lab or x-ray - can anyone help?

  2. #2
    Join Date
    Apr 2007


    This is a job aid from our local Medicare carrier. It states that modifier-25 is used when a procedure is billed on the same day. Labs/x-ray aren't procedures. We've had some denials from insurance companies that required us to appeal office visits that were "bundled" into ancillary services.


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