21 | Prolonged Evaluation and Management (E/M) services - Use only with highest level of care code for the category when the face-to-face or floor/unit service provided is prolonged or otherwise greater than that usually required for the highest level code. No effect on payment. Informational only. |
24 | Unrelated E/M service by the same physician during a post operative period - Use with E/M codes only to indicate that the E/M service was performed during a postoperative period for a reason(s) unrelated to the original procedure. Modifier -24 applies to unrelated E/M services for either MAJOR or MINOR surgical procedure. Failure to use this modifier when appropriate may result in denial of the E/M service. |
25 | Significant, separately identifiable E/M service by the same physician on the same day of a procedure or other service - E/M service or service by the same physician on the same day as the procedure or other service. The physician may need to indicate that on the day a procedure or service was performed, the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such, different diagnoses are not required for reporting of the E/M services on the same date. This circumstance may be reported by adding the modifier -25 to the appropriate level of E/M service. |
57 | Decision for surgery - Use with E/M codes billed by the surgeon to indicate that the E/M service resulted in the decision for surgery (E/M visit was NOT usual preoperative care). For E/M visits prior to MAJOR surgery (90-day post op period) only. Failure to use this modifier when appropriate may result in denial of the E/M service. |
Medical billing cpt modifiers with procedure codes example. Modifier 59, Modifier 25, modifier 51, modifier 76, modifier 57, modifier 26 & TC, evaluation and management billing modifier and all modifier in Medical billing. Modifier code list. How to use the correct modifier. HCPCS Modifier for radiology, surgery and emergency.
Sunday, August 1, 2010
Evaluation and Management Code Modifiers
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