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The Guide to Modifiers 25 & 59

January 23, 2020

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Does your practice struggle with Modifiers 25 & 59? Many practices we speak with are challenged with when and how to use both modifiers. Coronis Health has created a resource to help eliminate the guesswork. 

In this guide common questions, examples, and explanations are provided for everyday use and understanding of these modifiers. 

What is Modifier 25? The Current Procedural Terminology (CPT) definition of modifier 25 is as follows: Modifier 25 – this modifier is used to report an Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician.

What is Modifier 59? The definition of the 59 modifier per the CPT manual is as follows: Modifier 59: “Distinct Procedural Service” – Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day.

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