25 Modifier Reference Card: PRINT & SHIP OPTION
The Reference card acts as cliff notes on the proper use and documentation of the 25 Modifier.
Highlights include:
When you purchase these cards, NAMAS will provide 2 sample Templates for effective 25 modifier documentation when appropriate.
These cards are PRINTED to be pocket-sized at 5x7
A great reference tool for physicians, coders, and auditors.
Instant download electronic cards are also available
25 Modifier Information:
Compliance risks associated with Modifier 25 in healthcare billing refer to the potential violations of regulatory and reimbursement rules when using Modifier 25, a common modifier in medical billing. Modifier 25 indicates that a significant, separately identifiable evaluation and management (E/M) service was provided by a healthcare provider on the same day as another procedure or service. It's important to use this modifier correctly to ensure accurate billing and compliance with healthcare regulations. Here are some compliance risks associated with Modifier 25:
Documentation Requirements: To use Modifier 25 correctly, healthcare providers must ensure that the medical record contains distinct and separately identifiable documentation for the E/M service and the other procedure or service performed on the same day. Failure to provide adequate documentation can lead to compliance issues.
Overutilization: Excessive or inappropriate use of Modifier 25 can lead to allegations of upcoding or fraudulent billing, resulting in audits, investigations, and potential legal consequences.
We can help train your providers on Modifier 25 and conduct chart audit reviews. Our expert team at NAMAS is here to provide guidance and support to help your organization thrive. Contact us for assistance!
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