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Thread: Modifier -25 for Facility Coding of ED E/M

  1. #1
    Join Date
    Apr 2007
    Cincinnati, OH

    Default Modifier -25 for Facility Coding of ED E/M

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    I have been instructed to use a modifier -25 on every ED E/M code when coding for the facility. Mind you I am coding for the facility not billing for the facility.

    There was no reason provided regarding this "rule". I could not find anything about this in the CPT manual. I understand the need for a modifier -25 on the ED E/M code when additional services and/or procedures are performed such as a repair of a laceration. What I don't understand is why a modifier -25 would be used when labs or imaging studies are ordered. Aren't those processed through the CDM?

    If a source could be provided in your reply that would be greatly appreciated.

    Thank you in advance,

    Janice N White, RHIA, CPC, CTR
    Last edited by jnwhite80; 06-29-2011 at 11:41 AM.

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