Modifier 25: Optimizing E&M and Same-Day Procedure Coding

By: Victoria Moll, CPC, COC, CPMA, CRC, CPFC, CPRC

The strategic use of Modifier 25, particularly when dealing with same-day procedures within global periods, is essential. Throughout my career, I’ve seen multiple colleagues working on claim edits and would cheerfully apply whatever modifier the system pop-up advised them was needed. 


Claim edits are a handy reminder for potentially overlooked modifier applications, but a deepened understanding of where and when to apply them is critical. More and more payors are fighting back at the misuse by simply reducing payments or denying services.


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