Links are below...
25 Modifier
Significant separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service
The following conditions must be met to report modifier 25:
* The patient's condition required a significant, identifiable E/M service
above and beyond the other service provided or services beyond the usual
preoperative and postoperative care associated with the procedure that was
performed.
* These circumstances may be reported by adding the 25 modifier to the
appropriate level of the E/M service.
In the conditions above, the bold areas indicate the key phrases for the proper use of the modifier.
In the conditions above, the bold areas indicate the key phrases for the proper use of the modifier.
1. The phrase, “the patient's condition required” is extremely important. In other words, it was medically necessary for the patient to have these extra services on the same day that another procedure or service was performed.
2. The phrase, “a significant, separately identifiable E/M service above and beyond” the other service provided indicates that this extra service was clearly different from the other procedure or service that was performed.
3. The phrase, “services beyond the usual preoperative and postoperative care”
associated with the procedure emphasizes the fact that all procedures as defined in the Resource-Based Relative Value Scale (RBRVS) system of reimbursement that Medicare uses include a certain amount of preoperative and postoperative care in the reimbursement package. The 25 modifier should be used if extra work beyond the usual is performed. A good standard for judging whether the 25 modifier should be used is: If a physician in the same specialty area would agree after reading the clinical record that extra preoperative and/or postoperative work beyond what is usually performed with that service was performed, then it is proper to use the 25 modifier to indicate that extra work. To document the extra work performed, the clinical record should clearly indicate that extra or unusual work.
Primary considerations for modifier 25 usages are:
Why is the physician seeing the patient?
o If the patient exhibits symptoms from which the physician diagnoses the
condition and begins treatment by performing a minor procedure or an
endoscopy on that same day, modifier 25 should be added to the correct level
of E/M service.
o If the patient is present for the minor procedure or endoscopy only, modifier
25 does not apply.
o If the E/M service was to familiarize the patient with the minor procedure or
endoscopy immediately before the procedure, modifier 25 does not apply.
* If the E/M service is related to the decision to perform a major procedure (90-day global), modifier 25 is not appropriate. The correct modifier is modifier 57, decision for surgery.
* When determining the level of visit to bill when modifier 25 is used, physicians
should consider only the content and time associated with the separate E/M
service, not the content or time of the procedure.
http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/downloads/MM5025.pdf
Really you can google it and come up with ALLOT of helpful sites and information to fuel your teaching session!!!