tci E/M Coding Alert - 2016 Issue 5

Reader Question: Think Before Coding E/M with Every Surgery

Question: Can I charge for a 99213 and a 17250 on the same day at the same visit if I add modifier 25? The procedure was not scheduled prior to the office visit. Ohio Subscriber Answer: If your physician’s documentation supports a significant, separately identifiable E/M service, you can report 99213 (Office or other outpatient visit for the evaluation and management of an established patient …) and 17250 (Chemical cauterization of granulation tissue [proud flesh, sinus or fistula]). However, since Correct Coding Initiative (CCI) edits bundle the E/M code with the procedure code, you will have to...

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