Using Modifier 25 with E&M Service Codes

Modifier 25 is used to describe a "significant and separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service."

• This modifier is used only with evaluation and management (E&M) codes.
• The physician may need to indicate that the patient's condition required a service above and beyond what is expected for other services provided on the same day.
  
• Documentation within the medical record must support the level of E&M service reported.
  
• Different diagnoses are not required.
• Do not use modifier 25 to report an E&M service that resulted in a decision to perform surgery (see modifier 57).