office visit becomes minor procedure at ASC

[ncantello]

If a patient is seen in the plastic surgeons office and a decision is made to remove a lesion (minor surgery - 10 day global) in the ambulatory surgery center next door, is it possible to code for the office visit and the lesion removal or is the office visit included in the surgical package?

The guidelines I've read say that modifier 25 can be used on the office visit if the visit is a separately identifiable E&M service unrelated to the decision to perform the minor surgical procedure: my question is if we are reporting the office visit with a modifier 25 with place of service as the office, that won't get paid will it? Doesn't it have to be linked with the procedure that was decided on? The procedure would be billed as taking place at the ASC.

I'd appreciate any insight.

Thanks.