tci Part B Insider - 2007 Issue 23

REIMBURSEMENT: Don't Use 25 Modifier For Procedure The Day After E/M Visit

Leave HHA provider numbers off CPO claimsDo: When a patient comes in for an evaluation & management visit and then the physician decides to perform a minor procedure in the same session, you should go ahead and use the 25 modifier for the E/M visit, according to a new Frequently Asked Questions (FAQ) file from Part B carrier Palmetto GBA.  Don-t: But if the patient comes in for an E/M visit and then the doctor decides to bring the patient back the following day for a minor procedure, you shouldn't bill another E/M visit on the second day...

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