For physicians there is no concrete definition of significant procedure and sometimes the payers follow the the same rules as the facility and sometimes not so we usually do append the 25 to the OV with xrays.
As far as the vaccine administration is concerned, yes we do use the 25 on the E&M whether facility or physician as the admin codes are a status T for the facility. This is assuming of course that we are billing for a significant physician encounter in addition to the administration of the vaccine.
Again I would ask the instructor to clarify this statement so you can see where she is coming from.
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