Otolaryngology Coding Alert

Reader Question:

Modifier 57 and Billin E/M

Question: When I see a new patient for chronic cough, perform an evaluation and management (E/M) 99202 (office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: an expanded problem-focused history and examination; and straightforward medical decision-making) and then decide to perform a flexible fiberoptic layrngoscopy (31575) as well, what modifier should I use with the E/M code, -25 or -57?
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