Certified Professional Coder (CPC) Practice Test

Which modifier is added to an E/M code when a distinct, separately identifiable procedure is provided?

1. -24

2. -25

3. -51

4. -59

The correct answer is: -25

The modifier that is added to an E/M code when a distinct, separately identifiable procedure is provided is -25. This modifier indicates that on the same day as the E/M service, a procedure or service was performed that is separate from the E/M service and that it was necessary for the patient’s care. Using modifier -25 is crucial for proper coding and billing, as it allows for the reimbursement of both the E/M service and the procedure performed on the same day, as long as the documentation supports that they were independently warranted. This ensures that healthcare providers receive appropriate compensation for the additional work done during the visit. The other modifiers serve different purposes. Modifier -24 applies to an unrelated service during the post-operative period of a procedure, modifier -51 is used to indicate multiple procedures during the same session, and modifier -59 denotes distinct procedural services but does not specifically apply to E/M codes in the way that -25 does.