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26010 and modifier 25

Maiu Posted Fri 13th of April, 2012 12:11:26 PM

Can modifier 25 be appended to the visit if procedure 26010 was done?

SuperCoder Answered Fri 13th of April, 2012 12:23:14 PM

As CPT 26010 is a minor surgical procedure, Medicare won't allow you to bill modifier -25 unless it is separately identifiable. You should only be used -25 with the E/M that signifies separately identifiable means physician must should perform above and beyond the service provided. So if the physician has performed a separate history, exam and based on MDM, you could append modifier -25 to a level of E/M, but make sure you should linked different diagnosis with E/M code apart from what you are linking with CPT 26010.

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