Use modifier 25 when an E/M service is performed on the same day as a procedure, a preventive medicine service, or other medical service or procedure. Use our quick reference sheet and audit tool to determine when to use modifier 25, and which code to append it to. Using them consistently will help practices be reliable in their determinations and provide support in payer audits. Determining if there is a separate E/M is often a judgement call. Reasonable coders and practitioners can disagree.
- Modifier 25 | Audit Tool
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