What does modifier -25 signify?

Modifier -25 signifies that a significant, separately identifiable evaluation and management (E/M) service was performed on the same day as a procedure. This modifier is used when a patient receives an E/M service that is distinct from any procedure performed on the same day. It indicates that the physician evaluated the patient's condition and that the encounter warrants a separate billing due to the complexity or additional decision-making that went beyond the standard evaluation typically associated with the procedure.

For instance, if a patient comes in for a surgical procedure and also requires a thorough evaluation of an unrelated medical issue, the use of modifier -25 allows the provider to bill for both the procedure and the additional evaluation. This is essential for accurately capturing and reimbursing the level of care provided on that day since such an evaluation may require a significant amount of time, skill, or effort from the healthcare provider.

The other options do not correctly represent the function of modifier -25. A reduced service does not apply here since modifier -25 indicates a full service was performed in addition to another procedure, rather than a modification of service. A service provided with another does not convey the distinct nature of the E/M service; rather, it suggests a less defined relationship between the services. Finally, indicating a preventive service