tci ED Coding & Reimbursement Alert - 1999 Issue 2

Use Modifier -25 to Get Paid for an Emergency E/M Service and a Procedure

In the emergency department, there are no established patients. Thats why the ED services codes (99281-99285) dont make that a distinction. And obviously, there are no planned procedures in the ED either.The combination of these two facts should indicate to most emergency physicians that their E/M codes should almost always have the modifier -25 attached if they perform a procedure on a patient after the initial evaluation, says Todd Thomas, CPC, CCS-P, president of the Oklahoma City, OK, chapter of the American Academy of Professional Coders and principal of Thomas and Associates, an emergency medicine reimbursement consulting firm...

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