Internal Medicine Coding Alert

Published on Mon May 11, 2009 PDF

Question: An internist circled 99213 and 71020. Do I need a modifier to report this combination?

Utah Subscriber

Answer: Yes, to indicate the E/M is significant and separate from the minor E/M associated with taking an xray,append modifier 25 (Significant, separately identifiable evaluation and management by the same physician on the same day of the procedure or other service) to 99213 (Office or other outpatient visit for the evaluation and management of an established patient &).

Report the x-ray (71020, Radiologic examination, chest, 2 views, frontal and lateral) with no modifier.

You also may want to check your major payers policies.