Services performed on the same date, when related to the admission, may be reported separately appending modifier 25 to the other E/M service (ER visit or office visit).

Services performed on the same date, when related to the admission, may be reported separately appending modifier 25 to the other E/M service (ER visit or office visit).

• A. Yes, may be reported separately by appending modifier 25 to the related E/M service (ER visit or office visit)
• B. Yes, but only if the admission is to observation
• C. No, they must be billed together as one service
• D. Only if the patient is in inpatient status

Answer: (A)

Modifier 25 is used to show that an evaluation and management service on the same day as an admission is separate and independently billable from the admission itself. If a patient is seen in the ED or in the office and, on the same calendar day, is admitted, you can bill the E/M service separately by appending modifier 25 to that E/M code when the visit includes significant, distinct evaluation and management beyond what was needed for the admission decision. Documentation should reflect that this E/M service was performed as a separate, clinically meaningful encounter, not just a routine prelude to the admission. This applies regardless of whether the admission is inpatient or to observation, as long as the E/M service on that day meets the criteria of being separately identifiable. The other choices are not correct because they incorrectly limit or negate the possibility of separately billing the E/M service with modifier 25 when appropriate.

Modifier 25 is used to show that an evaluation and management service on the same day as an admission is separate and independently billable from the admission itself. If a patient is seen in the ED or in the office and, on the same calendar day, is admitted, you can bill the E/M service separately by appending modifier 25 to that E/M code when the visit includes significant, distinct evaluation and management beyond what was needed for the admission decision. Documentation should reflect that this E/M service was performed as a separate, clinically meaningful encounter, not just a routine prelude to the admission. This applies regardless of whether the admission is inpatient or to observation, as long as the E/M service on that day meets the criteria of being separately identifiable. The other choices are not correct because they incorrectly limit or negate the possibility of separately billing the E/M service with modifier 25 when appropriate.