• What is the 25 modifier and what is all the fuss about? 
  • What do CPT and Medicare mean by “pre-service time.” Do I have to document the minutes I spend on the E/M portion? 
  • What constitutes a separate and significant E/M? Does the documentation make or break when you can use the 25 modifier and bill both the E/M and the injection? 
  • What about new patients? Isn’t it always OK to bill an E/M and the injection?

We’ll finish with some case scenarios of when billing both an E/M with a 25 modifier and an injection are medically necessary and when billing both could put you at risk. We’ll also provide a link to Medicare’s calculation of pre-service time physician time to illustrate the physician evaluation time already valued in CPT codes. 

  • Interventional pain physicians, PM&R physicians, and other providers who provide interventional pain treatment.
  • Providers, managers and staff who work in pain management, or physical medicine and rehab (PMR).
  • Providers, managers, and staff in orthopedic and neurosurgical practices that treat pain.
*You will have access to the content for 30 days from the time you receive the access information. Please email education@karenzupko.com if you have questions.


Teri Romano, BSN, MBA, CPC CMDP
Consultant and Speaker

Teri Romano has over twenty-five years of consulting and teaching experience in the health care field. Ms. Romano works with physician groups and hospitals combining a background in clinical systems with solid approaches to operational and organizational problem solving.

Teri is co-developer and instructor for the national coding and reimbursement workshops sponsored by the American College of Surgeons, the Society for Vascular Surgery and the American Association of Neurological Surgeons. She also provides on-site customized coding and reimbursement courses to physician and hospital groups, specializing in neurosurgery, general surgery, vascular surgery, and vein well as E/M and surgical case audits to assist physician groups in their compliance activities. In addition, she consults with vein, vascular, general surgical, and neurosurgical practices on practice management issues including service line development, revenue enhancement, staffing models, appeals management and expense reduction.

Find out about more about Teri Romano, BSN, MBA, CPC CMDP
Consultant and Speaker

Audits and the Modifier 25 for Pain Zipinar
30 minutes

Medicare and private payers use predictive modeling to see if you may bill this code combination more than your peers. If you do, you may already be on your payer’s audit radar. 

Join us for this Zipinar (30 minutes start to finish!) to learn why payers are concerned about this code combination and how to avoid misuse and overuse.

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Coding Coaches