I have some records where normally the E&M would be denying as included in the procedure (Trigger points, etc), but the Physician is adding the 25 modifier, so it bypasses the Edits.
When I’m reviewing the records, they don’t meet the criteria for the "25" as there is nothing significant is noted. However, he writes the patient an RX and I was curious if anyone had anything on if this alone would constitute allowing the "25" in their opinion? Sometimes it’s the same RX as the prior visit, sometimes it may be trying a new RX. The Physical Exam is extremely limited (1 body system, if any) and the majority is just a little bit of Past hx.

Anyone have any strong opinions on whether to allow a 25 modifier for an E&M that normally would deny, but because there’s an RX written they’d allow it?