Modifier Use and Same-Day Vascular Ultrasound Services

Question:

I have a question regarding the appropriate use of modifiers when billing for E/M services performed on the same day as ultrasound procedures (e.g., 93880, 93922, 93978, etc.). Our billing team has been consistently appending modifier 25 to all E/M visits that coincide with same-day ultrasounds, and applying modifier 59 to each ultrasound code. We are a private practice and own the ultrasound equipment, so we do not use modifiers 26 or TC. Could you please confirm whether this approach is correct? Specifically, is it appropriate to routinely apply both modifier 25 to the E/M service and modifier 59 to the ultrasound codes for all in-office visits involving same-day ultrasounds? Thank you in advance for your guidance!

Answer:

Based on NCCI data, there are no procedure-to-procedure edits between office visits and vascular ultrasound codes such as 93880, 93922, or 93978, meaning these services are not inherently bundled and may be reported together when medically necessary and supported by documentation.

Because there are no NCCI conflicts, the use of modifiers 25, 59, or XU is not required for these code combinations. However, some payers may still require one or more of these modifiers for claims processing or system recognition when an E/M service and diagnostic ultrasound are performed on the same day.

It is important to review individual payer policies to determine when modifiers 25, 59, or XU may be necessary to ensure accurate claim submission and avoid denials.

*This response is based on the best information available as of 12/18/25.