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Modifier 25 - Significant & Separate

A White Paper Provided by Coding Strategies, Inc.

There are occasions that warrant both a patient encounter and a surgical or other significant procedure, but it may be difficult to determine when both services can be charged. According to authoritative coding guidance and Medicare regulations, the global surgical package includes all necessary services normally furnished before (preoperative), during (intraoperative) and after (postoperative) a procedure by the surgeon or by members of the same group within the same specialty. The global surgical package applies to physician (or qualified nonphysician healthcare professional) services in any setting, including inpatient hospital, outpatient hospital, Ambulatory Surgical Center (ASC) and physician office. 

April Fast Fact

The Coding Strategies monthly installment, Fast Facts, provides you with answers to the most common questions we receive regarding coding, compliance, and ICD-10-CM billing & documentation.