Tag: Modifier 25

Modifier 25

Understanding Modifier 25: A Comprehensive Guide

Often, a seemingly routine preventive visit or minor surgery can take an unexpected turn when a patient mentions a new concern, such as “Oh, by the way…” If a physician provides additional care beyond the originally scheduled service, you may be able to bill for a separate evaluation and management (E/M) service using modifier 25. […]
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Modifier 25 healthcare billing

Modifier 25: Essential Tips for Accurate Billing and Compliance

Description: Modifier 25: Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service. Navigating the Challenges of Modifier 25 in Healthcare Billing Modifier 25 healthcare billing in continues to be a source of frustration for healthcare providers. Health […]
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Bill Minor Procedure

How to Bill an E/M With a Minor Procedure

To determine the appropriate use of modifier 25, review this case study in otolaryngology. The Cigna Group has delayed the requirement for submitting documentation with claims that involve a 25 modified offices or other outpatient evaluation and management (E/M) service (CPT® 99212-99215) and a minor procedure. Despite the payer not enforcing this requirement, physician practices […]
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Using-Modifier–25-on-an-EM-Visit

Using Modifier – 25 on an E/M Visit

In recent years, there has been an increase in scrutiny regarding the use of modifier -25 to identify separate evaluation and management (E/M) services on the same day as another procedure. Insurers are now demanding documentation of such services both before and after payment, leading to a significant administrative burden for urology practices. The reason […]
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Use-CPT-Modifiers-to-get-paid-correctly

CPT Modifiers for Physicians to Get Paid

During a typical office visit, physicians may provide evaluation and management (E/M) services, minor procedures and more. The question is: Can they bill for each one separately? In some cases, the answer is no. In others, though, the answer is yes — but they must know what current procedural terminology (CPT) modifier to append. Modifiers […]
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Can-you-bill-EM-from-the-same-appointment-Image

Can you bill E/M from the same appointment?

Despite myths to the contrary, physicians are not prohibited from coding and billing for both preventive and problem-focused evaluation and management (E/M) services when they are performed during the same appointment. Motivated by a desire to avoid audits, many physicians tend to undercode for the work they perform. Others, however, are just unaware that the idea that […]
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chiropractic manipulative therapy code denial

E&M Denials When Billed With Chiropractic Manipulative Therapy: What to Do

Question: Why do my Evaluation & Management (E&M) codes keep getting denied when I bill them in conjunction with spinal manipulation? I have been receiving increasing inquiries regarding the denial of Evaluation and Management (E&M) codes 99201-99215 when billed with chiropractic manipulation. It appears to be happening on a wide scale, so I want to address […]
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