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Ep.26 Guidelines for Reporting an E/M Service with Modifier 25 and a Minor Procedure
In Episode 26 of Reimbursement Readiness: Business Tips for Wound Practice, Kathleen Schaum addresses a common coding practice that can create serious repayment risk during audits: reporting an evaluation and management service with Modifier 25 when a minor wound or ulcer management procedure is performed during the same encounter.
Kathleen reviews the 2026 NCCI Manual guidelines and explains why the decision to perform a minor procedure—and the related pre-, intra-, and post-procedure work—is generally included in the procedure payment. She clarifies that an E&M service may only be reported…
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