Effective medical billing and coding are essential for accurate reimbursement in medical practices. Two commonly used modifiers, Modifier 25 and Modifier 57, play a crucial role in indicating distinct services and decision-making processes.
Use Modifier 25 to signify that a significant, separately identifiable evaluation and management (E/M) service was performed by the same healthcare provider on the same day as another procedure or service. Procedures with a 0- or 10-day global period can be separately reported by using Modifier 25, assuming the E/M service is significant and separately identifiable. When the patient presents with the knowledge that the procedure is going to be done and no other conditions are addressed, the E/M is typically not supported, and Modifier 25 cannot be used. Below are a few scenarios for when to use Modifier 25: