What does CPT modifier -25 indicate?

• A. A significant, separately identifiable E/M service on the same day as another procedure
• B. A minor adjustment
• C. A procedure performed under anesthesia
• D. A documented but non-billable service

Answer: (A)

Modifier -25 shows that on the same day as a procedure, there was a significant, separately identifiable Evaluation and Management (E/M) service performed. This means the clinician did a distinct E/M visit in addition to the other procedure, and the E/M work is separate from the procedure’s routine pre- or post-operative care. The E/M service is documented and billed with its own code, with -25 attached to indicate it warrants separate payment because it involved additional decision-making or time beyond the procedure. It’s not about a minor adjustment, anesthesia, or non-billable services.