Modifier 25 vs. Modifier 57
Published on Sat Aug 14, 2010
Your modifier 25 claims should meet all of the following criteria:The E/M occurs on the same day as the surgical procedure The procedure following the E/M is minor (has a zeroor 10-day global period)The E/M service is both significant and separately identifiable from any inherent E/M component, and that the procedure involves the same physician (or one with the same tax ID) provides the E/M service and the subsequent procedure.Note that the diagnosis associated with the E/M service can be the same as the diagnosis associated with the same-day procedure, which means that the E/M prompted the follow-up procedure. Or, the diagnosis associated with the E/M service can be different than the diagnosis associated with the sameday procedure, meaning that the E/M was for a significant problem unrelated to the procedure.Use modifier 57 if the claim meets all of the following criteria:The E/M occurs on the same day of or [...]
