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Thread: Modifier 25 with labs and x-rays

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

    Default Modifier 25 with labs and x-rays

    AAPC: Back to School
    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
    Join Date
    Apr 2007


    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
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

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