Health Information Management

Messy modifiers: -25, -52, -58, -78, and -59 explained

Briefings on APCs, October 1, 2010

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Modifier -25

One commonly misused modifier is -25. You should only use this modifier to identify an E/M service that is significant and separately identifiable from a procedure that was performed on the same date of service. 

“Sometimes it seems to be a modifier that is assigned just because an E/M service was also charged, without much thought behind why the E/M was charged—almost a visual decision vs. a clinical decision based on documentation and coding rules,” says Debbie Mackaman, RHIA, CHCO, regulatory specialist for HCPro, Inc., in Marblehead, MA.

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