# Mod 25 Necessary



## carlosdela (Sep 26, 2008)

Modifier 25 states: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service.  

We all know that mod 25 is appended to the E&M or preventive code, but will it really make a difference for insurance payment if no modifier is appended and a procedure is performed with the E&M?


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## RebeccaWoodward* (Sep 26, 2008)

Yep...If it is a separate, identifiable E/M, chances are, the insurance company will deny the office visit as inclusive into the surgical procedure.  This happens to us when the poster forgets to add this modifier.


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## mbort (Sep 26, 2008)

ditto to Rebecca!!


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## ciphermed (Sep 26, 2008)

*mod -25*

I agree... the modifier should be appended when appropriate otherwise the reimbursement may be negatively impacted (item not paid). Modifier -25 applies to both facility and physician coding.


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