CodingIntel
  • What is CodingIntel
    • About
    • Become a Member
    • FAQ
  • Pricing
  • Free Resources
    • Overview
    • Blog
    • Everyday Coding Q&A
    • Newsletter
    • Can I get paid
    • Consultant Database
  • Coding Library
    • Coding Guides
    • Quick Reference Sheets
    • E/M Services
    • How Physician Services Are Paid
    • Prevention & Screening
    • Care Management & Remote Monitoring
    • Surgery, Modifiers & Global
    • Diagnosis Coding
    • New & Newsworthy
    • Speciality
    • Practice Management
    • E/M Rules Archive
    • Courses
  • Webinars
Sign in Become a Member

May 20, 2025

Modifier 25

Use of Modifier 25 may be applicable when an E/M service is provided on the same day as a procedure, a  preventive medicine service, or other medical service or procedure. Use this quick reference sheet to determine when to use modifier 25, and which code to append it to.

Using Modifier 33 | Quick Reference

Modifier 33 is used to identify certain screening and preventive services. This quick reference sheet addresses: when to use modifier 33, why to use it, screening colorectal cancer test, and planned screening colorectal test that converts to a diagnostic or therapeutic service.

Using Modifier 59 | Quick Reference

Modifier 59 is referred to by CMS as the modifier of last resort. It is often used when modifier 51 is the more accurate modifier. This quick reference sheet explains when, why and how to use it.

Coding Multiple Procedures | Examples with Modifiers

Biopsies and lesion destruction codes are often performed at the same patient visit. This leads to questions about bundling and modifiers. There are two steps to billing these correctly and avoiding denials: Check the total RVU values Check the NCCI edits. There is a step-by-step procedure for coding multiple procedures at the end of this […]

Modifier 51 or 59? How to Know Which to Bill?

Modifier 51 and 59 are both used on second and subsequent surgical procedures, when performed on the day of a primary procedure See also Modifier 59 quick reference sheet There are two modifiers commonly used in surgical specialties when billing two or more procedures at the same encounter.  Appending the correct modifier increases the likelihood […]

Billing for Multiple Surgical Procedures

When billing for multiple procedures on the same day, use this step by step procedure to determine if you should bill for more than one procedure, and if so, if you should use modifier 51 or modifier 59. It is critical to have access to National Correct Coding Initiative ((NCCI) edits in your software program.  […]

Modifier 57

Decision for Surgery.  An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service. The payment for major surgery includes E/M services provided on the day of and the day before a major surgical procedure, unless it […]

Surgical Modifiers

This article includes: Surgical modifiers with definitions Guidelines for billing multiple surgical procedures Modifiers in the post-op period Avoiding CPT® modifier mishaps Citations Members can also download the Global Surgery Coding Guide. Some of the information in this article and in the billing guide is the same. Billing for Surgical Services Before submitting a claim […]

Annual CPT® Changes Webinar

CodingIntel welcomes back Shannon McCall of HCPro for this review of changes that will go into effect January 1st, 2025. Exclusively for members.

Join now

Compliance for Medical Practices

Exclusively for members, this two module concentration includes guidance for developing an audit workplan, and how to locate source citations for common healthcare compliance scenarios.

Join today!

IRE Inpatient Determinations: Case Studiesoding for Prolonged Services | Webinar

Exclusively for members, this case-study focused webinar describes important ICD-10-CM Guidelines that establish the rules for these decisions.

Join today!

Latest Intel

Fueling Compliance: Cracking the Code on DSMT & MNT | Webinar

Overview … Read More...

Problematic Modifiers – 22, -52, -58, -78, -79 | Webinar

Overview … Read More...

Behavioral Health Screening and Testing

This article will review the codes and guidelines … Read More...

Anatomy of an Auditâ„¢: Complexity of Problem Addressed | Webinar

Overview … Read More...

Browse By Categories

Browse Content

  • Articles
  • Coding Guides
  • Everyday Coding Q&A
  • Videos
  • Can I Get Paid to
  • Blog
  • Webinars

Tags

behavioral health_cpt codes behavioral health_medication management care management CMS updates Code sets and reimbursement compliance issues critical care services dermatology_essential resource dermatology_procedures E/M frequency data E/M medical decision making E/M overview E/M reference sheets E/M rule changes FQHC general surgery_diagnosis coding general surgery_E/M services general surgery_modifiers general surgery_procedures global surgery issues HCC diagnosis coding hospital inpatient/observation ICD-10-CM coding level of service_Exam level of service_history level of service_MDM level of service_time medicare incident-to and shared services minor procedures modifiers office and other E/M Preventive and problem visits preventive services for medicare primary care_diagnosis coding primary care_E/M services primary care_essential resource primary care_modifiers primary care_other E/M services primary care_preventive services primary care_procedures prolonged care remote physiologic monitoring screening and counseling for behavioral conditions teaching physician rules telehealth

All content on CodingIntel is copyright protected. Any resource shared within the permissions granted here may not be altered in any way, and should retain all copyright information and logos.

  • What is CodingIntel
  • FAQs
  • Terms of Use
  • Privacy Policy
  • Contact

Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

Copyright © 2025, CodingIntel
A division of Medical Practice Consulting, LLC
Privacy Policy