# modifier -25 and radiology



## ercoder65 (Sep 15, 2009)

If performing an E/M in the office, and taking an xray of a patient, are you still inclined to append the 25 modifier to the E/M? I have been given conflicting answers on this question. I assumed an xray was considered a "procedure or service". Is there definitive articles on this subject? Thanks in advance.

Rich


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## jgf-CPC (Sep 15, 2009)

*25 mod*

Modifier 25 is used to identify a significant, separately identifiable evaluation and management service performed on the same day as another procedure or service by the same provider.


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## ercoder65 (Sep 15, 2009)

So, would you append -25 to the E/M? I am being told not too. Thanks!

Rich


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## jgf-CPC (Sep 15, 2009)

*Apply 25*

Yes you would append the 25 mod.


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## ercoder65 (Sep 15, 2009)

Thanks jgfisher!


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## WendyCPC (Sep 15, 2009)

25 modifier is not required for Radiology & Laboratory services. I think it is because they don't have pre or post op components and they are not considered a procedure. My rule of thumb is if it comes out of the surgery section of the CPT book I need a modifier for my OV.


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## ercoder65 (Sep 15, 2009)

Breezy,

Thanks for the info. Have you ever gotten a denial because a -25 had not been appended to an E/M on the same day as an xray? 


Rich


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## kumeena (Sep 15, 2009)

I agree with breezy


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## nc_coder (Sep 16, 2009)

I agree with Wendy.  We have a vascular lab in our practice.  Many times the patient sees the doctor first and then he decides to send them to the vas lab for a scan or ultrasound.  We have never put a 25 on the OV and have never been told we need to.


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## coderforlife (Sep 30, 2009)

*Mri*

would you use modifier 25 for an o/v where the doctor sends the patient to get an MRI?


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## FTessaBartels (Sep 30, 2009)

*-25 modifier*

The -25 modifier is used to identify a significant, separately identifiable E/M service when another service/procedure is performed on the *same date*, by the *same physician*.

If you are "sending the patient for an MRI" I would guess that you are not performing the MRI yourself, so no -25 modifier is needed on the OV.

F Tessa Bartels, CPC, CEMC


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## coderforlife (Oct 1, 2009)

*mri*

Thanks Tessa,
We have been debating at the office over the use of the modifier 25.  I have been looking for material on the subject to try and resolve our inconsistenices when using this modifier.  We are also dealing with the modifier 57 too.  I have read the guidelines and can see how different people can interpet it so differently.  We are now trying to understand the incident to stuff.  Crazy crazy days ahead.

Rich
	
	



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