AAPC - credentialing the business side of medicine

kumeena · #1 07-10-2009, 02:38 PM

Hi everyone

Pt came to clinic for IUD removal. After the removal Doctor did papsmear. Is it included in IUD removal or can he use the E/m with modifier 25 along with 58301 (IUD removal)

rinny · #2 07-10-2009, 06:40 PM

I have seen it billed with the IUD removal code then the E/M visit billed with the mod 25. Check your RVU's to see which one is the highest, that way you bill it first. Make sure that the dx code is attached to the correct CPT. Also, don't forget that some insurance carriers requires the Preventative code (ex 99395) which means no modifier can be billed.

kumeena · #3 07-12-2009, 05:03 PM

Thank you

CPalmer · #4 07-30-2009, 01:45 PM

Our office bills the office visit w/a mod 25, pap, and IUD removal.

imjsanderson · #5 07-30-2009, 03:28 PM

Modifiers can be used with preventative codes, but if this was only a pap and not preventative it would warrant a low level E&M with -25.