Coding · Definition
Modifier 25: Definition
Appended to an E/M code to show a significant, separately identifiable evaluation and management service was performed on the same day as a procedure.
This is a short definition only. The full explanation lives on modifier 25 in dermatology, which is the page to read if you are dealing with this on live claims.
Definition
In dermatology, modifier 25 usually appears when a patient presents for a scheduled lesion check and a new, unrelated complaint is evaluated and documented in the same visit.
The E/M work has to stand on its own: a separate history, examination and medical decision-making that would justify the visit even if the procedure had not happened.
For worked examples, payer rules and documentation requirements, read modifier 25 in dermatology. Return to the dermatology billing glossary.
See this term in your own numbers
A free claims audit reviews a de-identified sample of your dermatology claims and returns a line-item findings report.