Wiki 31575 and E&M billing

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mgiacomo

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An established patient comes into an ENT clinic for throat pain and laryngoscopy is used. Would 9921X and 31575 be appropriate to bill together? Does the modifier 25 need to be used even though both charges are for the same reason? I've seen contradicting information.
 
Based on the information you've given, I would say that both charges are justified- the Dr did the procedure to determine the source of the patient's throat pain if it could not be determined based on the exam alone. And YES, you would need the 25 modifier attached to the office visit.
 
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