tci ED Coding & Reimbursement Alert - 2000 Issue 2

Reader Question: Billing Starred Procedure

Question: Is the exam of the affected area in a starred (*) procedure included in the procedure code? Can we bill an evaluation and management (E/M) level with a starred procedure?Anonymous California SubscriberAnswer: CPT states that when the starred procedure is carried out at the time of the initial visit and the procedure constitutes the major service at that visit, code 99025 (initial [new patient] visit when starred [*] surgical procedure constitutes the major service at that visit) is listed in lieu of the usual initial visit code as an additional service.Medicare does not pay the code...

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