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Thread: Modifier 24 + 25

  1. #1
    Join Date
    Apr 2007
    Long Island/New York

    Default Modifier 24 + 25

    AAPC: Back to School
    can anyone direct me to the policy that states whether reporting modifier 24 and 25 on the same E/M code is appropriate or not? Thanks.

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Couple of sites...

    A physician performs a major surgery and within the global period sees the patient for an unrelated E/M visit. During this unrelated E/M visit, the physician determines the necessity of a minor surgery or other procedure. This minor surgery/other procedure is separate and identifiable from the E/M and unrelated to the original major surgery. Both the 24 and 25 modifiers are appropriate to add to the E/M code. The 24 modifier is appropriate because the E/M service is unrelated and during the postoperative period of the major surgery. The 25 modifier is also needed to identify that the minor surgery/procedure performed on the same day is separately identifiable from the E/M service.


    When a visit occurs on the same day as a surgery with no global days, but within the global period of another surgery AND the visit is unrelated to both surgeries, it is necessary to submit CPT modifiers 25 and 24.


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