what is modifier 25 global period 25 Significant Separately Identifiable Evaluation and Management Service by the Same Physician on the Day of a Procedure or Other Service It may be necessary to indicate that on the day a procedure or service identified by a CPT code was performed the patient s condition required a significant separately identifiable E M
Global Period Modifier 25 is appropriate when an E M service is provided on the same day as a minor procedure defined as one with a 0 day or 10 day global period Do not use modifier 25 when billing for services performed during a postoperative period if related to the previous surgery Per the NCCI general correct coding policies Modifier 25 may be appended to E M services reported with minor surgical procedures global period of 000 or 010 days or procedures not covered by global surgery rules global indicator of XXX
what is modifier 25 global period
what is modifier 25 global period
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An E M is related to and within the global period of a previously performed procedure This includes minor surgical procedures defined as a 000 or 010 day global period Patient The minor surgical procedure performed has a global period of 0 day or 10 day listed on the Medicare physician fee schedule JH JL and meets the definition of modifier 25 Global surgery is defined as all necessary services normally furnished by a surgeon before during and after a procedure
The global period defines the typical service and work performed and included and therefore already paid and therefore also defines what can and what cannot be reported concomitantly It would be wrong to bill twice for the same service which is called double billing Modifier 25 is used to signify that when a separate identifiable evaluation and management E M service was performed which can refer to two evaluation and management E M services or a procedure plus an E M service
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CPT modifier 25 is appended to an evaluation and management E M service code on a claim to indicate the code is a significant separately identifiable E M service by the same physician or other qualified health care professional on the same day of CPT codes 99291 99292 and modifier 25 for pre operative care or 24 Modifier FT for post operative care must be used with supporting documentation that the critical care was unrelated
Understanding the global period for procedures is a key element in assigning modifiers 24 and 25 Global periods are typically zero 10 or 90 days after the procedure and may include additional preoperative days Proper Use of Modifier 24 Use modifier 24 with the appropriate level of E M service in the following instances Modifier 25 should be appended if the procedure has a 10 or 0 day global period
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what is modifier 25 global period - Modifier 25 is used to signify that when a separate identifiable evaluation and management E M service was performed which can refer to two evaluation and management E M services or a procedure plus an E M service