# Usage of modifier -25 and -59



## Summer (May 9, 2012)

Good afternoon everyone,

Please advise,  should coders be adding a modifier -59 to every procedure when an E/M is being performed on the same day – for Medicare and / or Commercial carriers:   Example below:  all performed on the same day

Hospital or Office E/M with a modifier -25
EKG – modifier -59
Echo – modifier -59
and a stress test  - modifier -59

To me this appears to be overutlizing the modifier -59 however I'm told this is how we should billing.

Your thoughts and knowledge are welcomed!!


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## Jess1125 (May 10, 2012)

Summer said:


> Good afternoon everyone,
> 
> Please advise,  should coders be adding a modifier -59 to every procedure when an E/M is being performed on the same day – for Medicare and / or Commercial carriers:   Example below:  all performed on the same day
> 
> ...



Well, you would need the modifier 25 on the E/M because of the stress test on the same day. The EKG would need the -59 because of the stress test on same day as well. The echo and stress test, though, don't need any modifiers. 

Of course documentation has to support your billing of the E/M and EKG separately with the -25 and -59. 

Jessica CPC, CCC


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