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ACS, PAH COM & RNA Sponsored Practice Management Webcast Series March 12, 2008, E & M Coding From An Auditor s Perspective Evaluation and Management Services (E&M Coding) is a critical part of the

How to fill out modifier -25 is that

To fill out modifier -25 correctly, follow these steps:

1. Identify the patient encounter: Determine if the visit involved both a separately identifiable evaluation and management (E/M) service and a procedural/surgical service. Modifier -25 is used when the E/M service is significant and distinct from the procedure performed.
2. Assign the appropriate E/M code: Select the E/M code based on the level of complexity and documentation requirements for the evaluation and management portion of the visit. Ensure that the documentation supports the medical necessity for the E/M service.
3. Append modifier -25 to the E/M code: Once you have identified the patient encounter as requiring modifier -25, add the modifier to the E/M code. This indicates that a significant and separately identifiable E/M service was provided.
4. Bill the appropriate procedural/surgical service: In addition to the E/M code with modifier -25, correctly bill the procedural or surgical service that was performed during the encounter. Make sure the documentation supports the medical necessity of the procedure.

Who needs modifier -25:

1. Physicians performing procedures: Modifier -25 is commonly used by physicians who perform procedures along with an evaluation and management service during the same encounter. This is particularly relevant when the E/M service is significant and distinct from the procedure.
2. Surgeons: Surgeons who provide pre-operative and post-operative care in addition to performing the surgery may need to use modifier -25 to indicate the separate evaluation and management service provided during the encounter.
3. Primary care providers: Primary care providers may also need to use modifier -25 in situations where they provide a separate, significant E/M service on the same day as another procedure or service.

In summary, to correctly fill out modifier -25, identify the patient encounter, assign the appropriate E/M code, append the modifier to the E/M code, and bill the procedural or surgical service performed. It is important to understand when modifier -25 is needed and ensure that the documentation supports the medical necessity of the separate E/M service. This modifier is commonly used by physicians, surgeons, and primary care providers who provide a significant and distinct E/M service along with another procedure or service.

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What is modifier -25 is that?

Modifier -25 is used to indicate that a significant, separately identifiable evaluation and management service was performed on the same day as another procedure.

Who is required to file modifier -25 is that?

Medical providers, such as physicians and nurse practitioners, who perform evaluation and management services on the same day as another procedure.

How to fill out modifier -25 is that?

To fill out modifier -25, it should be added to the evaluation and management service code on the medical claim form.

What is the purpose of modifier -25 is that?

The purpose of modifier -25 is to indicate that a separate and distinct evaluation and management service was performed during the same visit.

What information must be reported on modifier -25 is that?

The information reported with modifier -25 should include documentation supporting the medical necessity of the additional evaluation and management service.