tci E/M Coding Alert - 2022 Issue Q2

You Be the Coder: Don’t Use Modifier 25 With Minor Global Period

Question: Encounter notes indicate that the provider performed osteotomies on the distal third of the radius and ulna after a level-four new patient office evaluation and management (E/M) service. The osteotomies did not involve realignment on an intramedullary rod. I reported 25350 and 25360 for the osteotomies and 99204-25 for the E/M and the payer denied the claim. How should I report for this encounter upon resubmission? Texas Subscriber Answer: You’ll report two codes for this encounter: a single code for both osteotomies and an E/M code. Also, your modifier choice was incorrect. On the claim, report: 25365...

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