Forum - Questions & Answers

Jan 2nd, 2013 - ljcoleman55

Modifier 25

If we are billing an office visit and an x-ray only, it it necessary to add modifier 25 to office visit CPT®?

Jan 2nd, 2013 -

re: Modifier 25

No; yu only put 25 on a procedure code that has a 000-010 Global day and its Above and beyond normal pre op care.

Jan 2nd, 2013 - nmaguire   2,606 

re: Modifier 25

You should not need the modifier -25 on E/M code when also performing a diagnostic test.
Unless, payer tells you they want it.

Jan 3rd, 2013 - Codapedia Editor 1,399 

re: Modifier 25

I am hearing from coders around the country that more payers have edits in place that require using modifier 25 on an E/M when almost anything is done on the same day: diagnostics, injections, immunizations, and of course, procedures.

The problem for us in keeping straight which require it and which don't, when it doesn't strictly follow coding rules.



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