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Thread: Modifier 25 dispute

  1. #1

    Default Modifier 25 dispute

    AAPC: Back to School
    I work for an large physician based hospital and we are getting denials from our billers stating that we need to append an 25 modifier for our EM codes with a 81003. Does anyone have documentation supporting this. Thanks for any help!

  2. #2
    Join Date
    Apr 2007
    Kansas City, MO


    have you asked them for documentation since they are the ones giving out the "denials"? It may be a payer requirement. Otherwise, no, I don't think you will find an "official" rule on this.
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

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