Neurosurgery Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: Is it appropriate to append modifier -25 to 95970 or 95974 when the patient presents for follow-up or needs adjustment to a neurostimulator?

Texas Subscriber
 

Answer: Modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) should be appended only to E/M codes.
 
If a "separately identifiable" E/M service was performed with 95970 (electronic analysis of implanted neurostimulator pulse generator system ... simple or complex brain, spinal cord, or peripheral ...) or 95974 (... complex cranial nerve neurostimulator pulse generator/transmitter ...) report the appropriate E/M visit with modifier -25. For instance, if the patient exhibits symptoms such as recurrent tremor, the physician's E/M of those symptoms could support a billing of a separate office visit. If the follow-up service is provided for previously scheduled analysis only, do not report a separate E/M code.