Health Information Management

Q&A: Follow CMS' coding guidelines when using modifier -25

APCs Insider, August 1, 2008

QUESTION: Are there any guidelines with respect to the appropriate use of modifier -25 for hospital outpatient reporting? It is my understanding that, for Medicare, we should always append modifier -25 to the facility emergency room (ER) evaluation and management (E/M) codes whenever we bill a procedure with a status indicator of ?S? or ?T? on the same date of service. What about the other outpatient evaluation E/M codes? Should we always append modifier -25?

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