Is Your Medical Biller Using Modifier 25?

To understand modifier 25, let's define what it is. Modifier 25 is Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. This modifier can only be used with an Evaluation and Management service. It has to be above and beyond the usual preoperative and postoperative encounter with the procedure. Using this modifier does not require you to use another diagnosis to bill. It is most important that the Evaluation and Management level should meet its key components. Make sure that when using this modifier that it meets medical necessity. Below is an example of when this modifier would be used.
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