Ophthalmology and Optometry Coding Alert

Questions: When billing an office consultation with a minor office surgery performed on the same day, is modifier -25 or any other modifier required?

Kansas Subscriber

Answer: Modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) should be appended to evaluation and management (E/M) services codes when a minor surgical procedure is performed by a physician on the same day that the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided, or beyond the usual preoperative and postoperative care associated with the procedure performed. The minor surgical procedure is usually a starred (*) procedure which carries a global surgical package of 0 to 10 days.