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Wiki 46600 Anoscopy with E/M

amwittler

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Is it appropriate to code 46600 with an E/M? The pt is coming into the office for hemorrhoids.
 
As long as there is a separately identifiable reason to bill for an E/M, there is no reason these codes cannot be billed together. It always comes down to the documentation.

If an E/M is supported by the documentation, just remember to add a Modifier -25 to the E/M.
 
Has the diagnosis already been established and does the documentation state they are here for anoscopy for hemorrhoids? Or was the encounter for pain or bleeding or whatever and the provider decided to perform the endoscopy to establish the cause?

If the only work performed was in taking a history for the pain/bleeding, doing an exam and then deciding to do the anoscopy then a significant, separately identifiable E/M is probably not supported. A dollar amount would be included in the reimbursement for the procedure. However, without the complete documentation it's really not possible to give a more definitive answer.
 
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