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Orthopedic Coding Alert

Test Yourself With Real-Life Modifier 25 Scenarios

See if you arrive at the same coding conclusions our experts recommend. Last month you learned three easy ways to know when you're on the right track with reporting modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service): • Verify the service is significant • Check for additional work • Look for service "pre-planning." Now take another look at the coding examples we shared and decide how you would handle them. Then check your answers against our experts' advice. Scenario 1: A Semi-Planned Follow-Up Visit Your orthopedist sees Mrs. Jones in the office and gives her a prescription for pain medication to help her wrist pain. He says that if the medication doesn't help, he'll give her a wrist injection when she returns. Mrs. Jones returns two weeks later for the injection. Your physician completes another [...]


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