When and How to use this coding adjective Modifier -25  

Category: Coding

The focus of this article is to discuss Modifier -25:

• When and how to use this modifier
• Tips for physicians and their staff
• The impact on billing

Modifiers are two (2) digit numeric or alpha characters that are reported with a CPT code when appropriate.  They provide Medicare and commercial payers with additional (and essential) information needed to process a claim.  Modifiers provide the means by which the physician can "flag" a service that has been altered by some special circumstances without changing the basic CPT code description.

The importance of the -25 modifier is that it allows physicians to obtain reimbursement for services rendered that would otherwise be denied if the modifier was not attached.  It alerts the payers that another significant separately identifiable E/M service was done by the same physic...