I do not think the billers should be automatically adding the -25 modifier.
As many times as I've explained to our physicians that if the reason for the visit was to have the procedure (e.g. injection or burn dressing change), then there is no separatley identifiable E/M UNLESS they are evaluating and managing something else entirely ... I have one provider who ALWAYS marks the E/M on every visit.
Our billers will put through the charge (WITHOUT the -25 modifier), just as it was marked on the superbill and then it will eventually appear on my global denial report. ARRGH!
But, as frustrating as it is, I'd rather have it this way than be sending through fraudulent claims and getting reimbursed for a "significant separately reportable" service that was neither significant nor separately reportable.
Just my two cents ...
F Tessa Bartels, CPC, CEMC
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