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Thread: Modifier 25 and admit codes?

  1. #1

    Default Modifier 25 and admit codes?

    AAPC: Back to School
    I am having some confusion with when to use the 25 modifier with an admit code. I know when patient is scheduled for day surgery for lets say a cath, we cannot bill the admit code. However, our doctor sees the patient in the ER as a consult and admits the patient to the hospital and also plans for the cath and stent to be done, can we then use the admit code and justify with -25? Or would that be wrong? Thank you, Gail.

  2. #2


    Would anyone have an answer to this? Another way to word it would be lets say patient is in observation status, admitted by my doctor, then later he decides to do stent and cath, can I code for the E&M admit code and the procedure on the same day justifying it with a -25 modifier? Any help is appreciated!!!

  3. #3
    Join Date
    Apr 2007
    San Diego


    Yes, if the pt comes in thru the ER and the doc also does cath/stent the same day you can bill the E/M with modifer 25

  4. #4


    Can you give me anything in writing that supports this? Thank you so much!

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