What is the difference between modifier 24 and modifier 25?
Modifier 24 refers to the evaluation and management services provided to the patient on the day of a surgical procedure unrelated to the procedure itself. Modifier 25 identifies the evaluation and management services as unique services provided on the same day by the same medical professional.
Is modifier 25 needed for EKG?
Yes, you need to add a -25 modifier to your E&M service when billing in conjunction with an EKG or injection admin service done on same DOS. You’re sure to get a bundling denial without it.
Can I use both modifier 24 and 25 together?
Both the 24 and 25 modifiers are appropriate to add to the E/M code. The 24 modifier is appropriate because the E/M service is unrelated and during the postoperative period of the major surgery.
When to use modifiers 25 and EP in CPT?
Modifier 25 indicates significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service. Modifier EP indicates routine Healthy Kids/EPSDT screening. Modifiers may be appended to HCPCS/CPT codes only if the clinical circumstances justify the use of the modifier.
When do you not use the 25 modifier?
Do not use a 25 Modifier when billing for services performed during a postoperative period if related to the previous surgery. Do not append Modifier 25 if there is only an E/M service performed during the office visit (no procedure done). Do not use a Modifier 25 on any E/M on the day a “Major” (90 day global) procedure is being performed.
Do you report modifier 25 on Procedure Code 99211?
Modifier 25 should not be reported on procedure code 99211. Do not append the following E/M codes that are clearly for new patient only: Note: The codes listed above are listed as new patient codes and are automatically excluded from global surgery package edit.
Is the CPT code 92002 a new patient code?
This modifier should not be submitted with E/M codes that are explicitly for new patients only: CPT codes 92002, 92004, 99201-99205, 99281, 99285, 99321-99323, and 99341-99345. These codes are ‘new patient’ codes and are automatically excluded from the global surgery package, meaning that they are reimbursed separately from surgical procedures.
