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Modifer 25 - When billing for both

  1. #1
    Default Modifer 25 - When billing for both
    Medical Coding Books
    When billing for both an E/M and an additional procedure i know you append modifier 25 to the E/M...what procedure do we leave the modifier 25 off..meaning which status indicator procedures?

    A foley Cath was done in the ER 51702 and i rec'd an edit. But, that has status indicator X so i believe modifier 25 should be on the E/M?
    Thanks.

  2. #2
    Default
    51702 has a "000" global day value so any E/M billed on the same day will deny as included in the global period for that procedure unless you have a significantly separate E/M and add the 25 modifier.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

  3. #3
    Default
    Great! That's what I thought. Thank You.

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