Modifier -25 Use in Dermatology
Modifier -25 frequently is integral to the description of patient visits in dermatology. Dermatologists use modifier -25 more than physicians of any other specialty, and in recent years, more than 50% of dermatology evaluation and management (E/M) visits have been appended with this modifier.
Practice Points
- Frequent use of modifier -25 is appropriate in routine, high-quality dermatologic practice.
- The global period (0, 10, or 90 days) of a procedure dictates if evaluation and management services provided on the same day of service as the original procedure can be billed separately.
- Careful documentation by the dermatologist can help clarify the precise basis for the use of modifier -25.
Final Thoughts
It is clear that frequent use of modifier -25 is appropriate in routine, high-quality dermatologic practice. Simultaneous provision of E/M services and minor procedures often is in the patient’s best interest, as it minimizes unnecessary office visits and expedites treatment. When modifier -25 is appropriately appended, careful documentation by the dermatologist can help to clarify the precise basis for its use. Recent NCCI edits provide guidelines for use of this modifier that can be adapted by individual dermatologists for particular patient circumstances.2
