What does the modifier -25 signify in coding?

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The modifier -25 is used in coding to indicate that a significant, separately identifiable evaluation and management (E/M) service was provided by the same physician on the same day as another procedure or service. When the modifier is appended to the E/M code, it signifies that the physician performed a patient evaluation that was distinct from any other service rendered, justifying the use of both the E/M service and the additional procedure codes.

This is particularly important to ensure that healthcare providers are appropriately reimbursed for the services they provide without them being bundled into a single payment. By using modifier -25, coders can clarify that the E/M service warranted separate billing due to the complexity or time involved in the evaluation, even when performed on the same day as a procedure. This supports the integrity and accuracy of billing while reflecting the true scope of services provided to the patient on that visit.

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