Urology Coding Alert

Question: Can I bill Medicare for an office visit and cystoscopy on the same day using a modifier 25? California Subscriber Answer: Yes, you can bill a cystoscopy (52000, Cystourethroscopy [separate procedure]) and an office visit such as 99213 (Office or other outpatient visit for the evaluation and management of an established patient ...) on the same day as long as the urologist's documentation supports the significant, separately identifiable E/M service. Append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to 99213 to indicate that your urologist performed a separate E/M service. Example: A patient comes to your office for a routine follow-up cystoscopy, and after the procedure the urologist reviews the results of the examination with the patient indicating that he found a recurrent bladder tumor. The urologist counsels the patient and coordinates his [...]