tci E/M Coding Alert - 2022 Issue Q3

Reader Questions: Remember Counseling May Qualify as a Separate Service

Question: Can a GI specialist bill for alcohol abuse counseling and intervention in addition to an E/M visit? AAPC Forum Participant Answer: Yes. Counseling codes, according to the CPT® Evaluation and Management/Preventative Medicine Services guidelines, “are distinct from evaluation and management (E/M) services that may be reported separately with modifier 25 when performed.” What this essentially means is that it’s likely the patient did not come into the gastroenterologist’s office to discuss alcohol abuse, so a separate discussion with its own treatment trajectory will take place, warranting a separate code. Consider the following: A patient...

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