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Modifier 25 with labs and x-rays

  1. #1
    Rome, Georgia Chapter - Rome Coding Professionals
    Default Modifier 25 with labs and x-rays
    Medical Coding Books
    Does anyone know where to find the information that if you bill an E/M with a lab and or x-ray you do not need to append the 25?

  2. #2
    Modifier 25 indicates that on the day of a procedure, a significant, separately identifiable E/M service was performed that was above and beyond the usual pre- and post-operative care associated with the procedure or service. X-rays and labs have an "XXX" global day designation which means the global period does not apply, so you should not need a modifier on the E/M if the only other service was an x-ray or lab.
    The designations are in the Medicare Physician Fee Schedule in the Global days column.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

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