Modifiers – 24 & -25: Get Paid More of What You Deserve


Modifiers -24 and -25 are costing you. They are both in the top ten reasons for Medicare denials, and because they are regularly applied incorrectly and excessively, you’re not being paid for many of the additional services you provide. So, basically you’re providing patient services for free, and who can afford to do that?

So, how can you improve your usage of these tricky modifiers? That’s where Maxine Lewis, CMM, CPC, CPC-I, CCS-P comes in. She is a national coding expert with over 35 years of experience. During her training session she will provide you with the proven strategies you need to utilize these essential modifiers more accurately, decrease your related denials and boost the reimbursement you receive for these additional services.

Modifier -24 and -25 are easily confused because of their similarities. Both are used to report E/M services when they are significant and separately identifiable to the original service. However, these modifiers are notably different:

• Modifier -24 should only be used after a major procedure with a global surgical period of 90 days or after a minor procedure with a global surgical period of 10 days.
Modifier -25 should be used when the E/M service is rendered by the same physician on the same day of a procedure or other service with 0 day global period.

With Maxine’s help, you can get paid for more of these additional services and overcome the most common coding errors related to these confusing modifiers. Here are just a few of the proven strategies you’ll be able to implement after completing her practical 60-minute training session:

1- Easily identify the root of the patients visit and avoid applying -25 and significantly reduce your denials
2- Prevent modifier -24 driven audits by not inadvertently reporting post-op services as separately payable when they’re not
3- Stop missing reimbursement opportunities with simple methods to hone in on those services that really deserve modifier -25
4- Get paid for additional services when the procedure has the triple-zero global surgery indicator (“000”) – the correct modifier is different than you think
5- Speed up your payments with proven method to correctly calculate exact timeframe of the global period – be right about modifier -24 every time
6- And so much more…

Modifiers -24 and -25 play a significant part in you receiving correct reimbursement in a timely manner for the services you provide. Even if you are a coding veteran, you’ll gain immediately-usable steps to improve your additional services pay-up, stop lost reimbursement, and increase your overall revenues. Start getting paid more of what you deserve.

Meet Your Expert

Maxine Lewis
CMM, CPC, CPC-I, CCS-PPresident, Medical Coding Reimbursement Management

Maxine is a nationally recognized lecturer, author and consultant in the healthcare industry combining more than 40 years of practical experience in the medical office with an in-depth understanding of coding, reimbursement and management issues of the medical profession. She is the author of “Working with Insurance and Managed Care Plans” and “Medicare Rules and Regulations”.

Her special interest in the Medicare program has provided expertise not only in the federal program but its ramification and implications with other third party payors. Her educational training simplifies often-complicated issues in the reimbursement arena.