tci ED Coding & Reimbursement Alert - 2008 Issue 4

Reader Questions: Let Payer Guide 25 Use on FAST Claim

Question A patient reports to the ED after crashing his snowmobile into another snowmobile. He was unconscious when he arrived, and had signs of generalized trauma on his abdomen (bruising). The patient awakes while being examined and complains of severe abdominal pain. The physician performs a level-five E/M, then conducts a FAST exam. Should I attach modifier 25 to the E/M code, or is that unnecessary? Maine SubscriberAnswer: It depends on the insurer. When the physician performs an E/M, then conducts a FAST (focused assessment by sonography for trauma) exam, you will likely have to append modifier 25 (Significant...

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