Otolaryngology Coding Alert

4 tips show you what to do when you get that E/M denial. The next time you don't know what to do with an E/M denial, take these four actions: 1. Check Documentation Meets Modifier 25 Criteria You should first verify that your otolaryngologist's chart note supports billing an E/M with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of another service or procedure). Per CPT guidelines, minor procedure has a small E/M built into it. In order to be eligible to bill for an E/M service with a procedure, the documentation must show that the E/M performed was medically necessary as well as a significant separate and identifiable service from the procedure or other service. Example: A patient presents for an allergy injection, such as 95115 (Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection) in [...]