Modifier 25 Review – Ophthalmology Management
Using modifier 25 will often get your exam claim paid — but know when to use it correctly.
Are you allowed to bill for an eye exam on the day of a minor surgical procedure? If you haven’t looked at this question lately, you may be surprised. Using modifier 25 will often get your exam claim paid — but know when to use it correctly.
This article addresses the following questions:
- What is modifier 25?
- What types of procedures or services require the use of modifier 25?
- Must we have more than one diagnosis on the claim to use modifier 25?
- When is the use of modifier 25 not appropriate?
- Does use of modifier 25 affect the value ascribed to the exam?
- Will the use of modifier 25 attract attention from Medicare?
- What is the best way to document a minor procedure?
This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:
https://www.ophthalmologymanagement.com/issues/2022/october-2022/coding-amp;-reimbursement