I always recommend this site as the go-to for modifiers:
https://www.wpsgha.com/wps/portal/mac/site/claims/guides-and-resources/modifiers/!ut/p/z1/jVFBasMwEHxLDz7au4lJML25Ia0pNimFtKouQYllWcXWGkmOoa-vIKdC63pvu8zMDjPAgQE34qqV8JqM6ML-wbenl6LYFqsMy8O6Qsyrx7d0n5UP2esK3mcAKT6lwJfw8Y_JcRl_BsDn5Z__exASWNtqVyngg_BtrE1DwNSoa-liYerYSkejvUgHrKdaN1paF2zxGeFbMAusqY7OtxZyc06z4MHKRlppk9GGc-v94O4jjHCapkQRqU4mF-oj_I3SkvPAfiJh6I9H9lUW-LnprmV-9w0Q9LY1/dz/d5/L2dBISEvZ0FBIS9nQSEh/Of course you can always Google which modifier you need more help with, by doing something like this: "25 modifier fact sheet". I just like the way the WPS site lays them out.
In the case of billing an E/M and a procedure on the same day, assuming the patient is not in a global period, it would look like this:
9921X-25
(procedure code on next line with no modifier)
So, here is an example:
99213-25
17110
25 and 24 and 24/25 modifier(s) ONLY go on E/M codes, never on procedure codes.
Also of importance is that the modifier affecting payment ALWAYS goes before the informational modifier, if both are needed on the line item. An example would be a hospice patient, seen for a non-related hospice service. It would look like this:
99213-25-GW
17110-GW
Putting the 25 first affects the payment, and the GW is informational.
Another example would be this:
99213-25
11730-59-TA
29540-59-LT
Here you are showing that the 11730 is separate from the 29540, by using the 59 modifier(affects payment), and then using the T modifier to show which toe had surgery(informational modifier), and that the 29540 is separate from the 11730 with the 59(affects payment), and that the LT shows which foot was strapped(informational modifier). The 25 on the E/M shows the E/M was unrelated to the 11730 and the 29540. (payment modifier)
Some further information:
1. Never use a 51 modifier, as insurance company claim processing software automatically applies this modifier to reduce payment for multiple surgeries.
2. Be careful when applying laterality modifiers LT and RT. Certain procedures, such as 10060,10061, and 11042 to name a few are "skin" procedures, and skin has no laterality, it is one continuous organ. So there is no left or right side to it, and adding the LT or RT modifiers can cause issues.
