Mastering Modifier 25: Compliance, Coding, and Clarity

This course provides medical coders, billers, physicians, and compliance professionals with an in-depth understanding of the most frequently used and commonly misunderstood modifier in medical coding: Modifier 25. Participants will gain clarity on when and how to appropriately apply this modifier in relation to the global surgical package, compliance and coding. Through detailed explanations, real-world case studies, and practical scenarios, learners will develop the skills necessary to accurately identify when additional E/M work is significant enough to warrant separate billing, understand the preoperative evaluation time built into procedure codes, and avoid common pitfalls that lead to claim denials. The course addresses both CPT and Medicare guidelines, highlighting critical differences and payor-specific requirements.

Learning Objectives

• Differentiate when E/M services are significant and separately identifiable

• Defend preoperative time when determining if additional E/M work is significant Implement Proper Documentation Strategies

• Logically separate E/M documentation from procedure documentation

• Confirm the documentation meets the criteria for the selected level of E/M service

• Recognize insufficient documentation that does not support Modifier 25

Target Audience

• Certified medical coders (CPC, CCS, CCS-P)

• Medical billers and revenue cycle specialists

• Physicians and advanced practice providers

• Practice managers and administrators

• Compliance officers and auditors

• Clinical documentation improvement specialists

• Healthcare consultants

• Coding educators and trainers

Join Christine Banks and earn one CEU with our live one-hour Webinar!

Start time: 12:00 pm CST on July 22, 2026