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modifier -25 and radiology

  1. #1
    Default modifier -25 and radiology
    Exam Training Packages
    If performing an E/M in the office, and taking an xray of a patient, are you still inclined to append the 25 modifier to the E/M? I have been given conflicting answers on this question. I assumed an xray was considered a "procedure or service". Is there definitive articles on this subject? Thanks in advance.

    Rich

  2. #2
    Smile 25 mod
    Modifier 25 is used to identify a significant, separately identifiable evaluation and management service performed on the same day as another procedure or service by the same provider.

  3. #3
    Default
    So, would you append -25 to the E/M? I am being told not too. Thanks!

    Rich

  4. #4
    Default Apply 25
    Yes you would append the 25 mod.

  5. #5
    Default
    Thanks jgfisher!

  6. #6
    Default
    25 modifier is not required for Radiology & Laboratory services. I think it is because they don't have pre or post op components and they are not considered a procedure. My rule of thumb is if it comes out of the surgery section of the CPT book I need a modifier for my OV.

  7. #7
    Default
    Breezy,

    Thanks for the info. Have you ever gotten a denial because a -25 had not been appended to an E/M on the same day as an xray?


    Rich

  8. #8
    Default
    I agree with breezy

  9. Default
    I agree with Wendy. We have a vascular lab in our practice. Many times the patient sees the doctor first and then he decides to send them to the vas lab for a scan or ultrasound. We have never put a 25 on the OV and have never been told we need to.

  10. #10
    Default Mri
    would you use modifier 25 for an o/v where the doctor sends the patient to get an MRI?

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