E/M Coding:
Navigate NCCI Edits and Payer Policy to Understand Denial
Published on Wed Oct 01, 2025
Question: We are receiving denials for CPT® code +99417 indicating included. We are billing a level 5 evaluation and management (E/M) with modifier 25 and +99417 without modifier, with separate procedures on the same day. We are experiencing +99417 denials as included while the E/M service (99215-25 or 99205-25) and the procedure are being paid (all codes meet time requirements [...]