tci General Surgery Coding Alert - 2019 Issue Q4

Reader Question: Check Modifier 25 Opportunity

Question: Our surgeon examined a patient in the office who had a head laceration. After the exam, the surgeon sutured the wound. Can we report an E/M code in addition to the repair code? Nebraska Subscriber Answer: From what you’ve described, you should not separately report an E/M code along with the repair code. Remember that every procedure has a small amount of E/M built into it, so you won’t typically bill a separate E/M with an office procedure. Exception: If the surgeon meets the following criteria, you may report a separate E/M along with a procedure...

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