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Common Scenarios for Using Modifier-25 When evaluating whether to use Modifier-25, healthcare providers should consider several common scenarios where its application is appropriate: During a scheduled procedure, the physician identifies and evaluates a new medical condition that requires significant additional work A patient comes in for a scheduled procedure but reports new or worsening symptoms that require a separate evaluation A patient receives preventive services and requires evaluation of a chronic or acute condition during the same visit Follow-up visits that involve both wound care and evaluation of other medical conditions Documentation Requirements for Modifier-25 Proper documentation is crucial when using Modifier-25