Wiki Modifier 25?

[TLC]

My employer is asking me to use a modifier 25 on every E/M visit if we do anything else at all. Whether it be a procedure,injection,UA dip, etc. I don't feel this is correct. However they say there getting denials from insurance companies when there is no modifier??? Does anyone have a thought. Thanks I don't want those "red flags" to start flying.

 

[mvfenger]

In the clinic I code for, we use modifier 25 on all injections and most procedures. We do not use it for any type of lab or radiology, pap smears, wet preps, etc.
Hope this helps!

 

[ollielooya]

A blanket policy to add modifier 25 on every procedure is dangerous indeed. Depending on the scenario some procedures in addition to the EM visit may be accounted by adding modifier 25, but documentation must warrant it. It's all in the chart notes and must be significant and separate, the key word being "significant." If you will use this forums's search function, you can type in modifier 25 to pull up lots of helps on this topic. There has been much written about this. Your concerns are justifiable.