Modifier -25 and the New 2021 E/M Codes: Documentation of Separate and Distinct Just Got Easier

Howard W. Rogers, MD, PhD

Cutis. 2021;108(3):131-132, 162.

Abstract and Introduction

Abstract

The ability to provide same-day evaluation and management (E/M) and procedure services (reported with a modifier -25) is critical to efficient dermatologic care. However, insurer policies that deny or decrease payment modifier -25 and increased frequency of insurer modifier -25 audits are challenging dermatologists’ ability to deliver timely, patient-centered care. Understanding the documentation requirements that qualify for billing the minor procedure on the same day as an E/M service is critical for passing medical record reviews. Moreover, the new E/M codes for 2021 have notably decreased documentation burden and have simplified reporting modifier -25.

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