Medicare Compliance & Reimbursement - 2003 Issue 2
Surgical Procedure Code + E/M Code Can Be Correct Coding
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Article Overview
This article discusses general billing and coding distinctions between evaluation and management services and procedure or surgical services. It is aimed at coders, billers, and other revenue cycle staff who need to understand when separate reporting may be considered and how global-period timing and procedure type factor into the discussion. The article presents broad guidance on starred, nonstarred, minor, and major procedures and mentions commonly used modifiers in this context.
Why This Topic Matters
Correctly distinguishing separate E/M and procedure reporting is important for compliant claim submission and for avoiding inappropriate bundling or missed reporting opportunities. The topic is especially relevant when the same encounter includes both assessment and a procedure-related service.
What You Will Learn
- How the article frames separate reporting of evaluation and management services with procedures
- How the discussion distinguishes starred, nonstarred, minor, and major procedures
- How global-period timing is presented as part of the topic
- Which modifiers are referenced in the guidance
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Compliance staff
Modifiers Discussed
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