Wiki 59 or no 59

[hsmith67]

Please help me settle a difference of opinion. Which is the correct way to bill an office visit and I&D (10060)?

A) 99213- 25 and 10060
B) 99213-25 and 10060-59
C) 99213 and 10060-59

Thanks,
Hunter Smith, CPC

 

[CodingKing]

10060 only unless the E&M is documented as significant and separately identifiable.
Otherwise A. Modifier -25 on E&M is the attestation that E&M is significant and separately identifiable..

Modifier 59 would only be used if its multiple surgical procedures, there is an NCCI edit between the two and meets criteria for separate reporting.

 

[hsmith67]

10060 only unless the E&M is documented as significant and separately identifiable.
Otherwise A. Modifier -25 on E&M is the attestation that E&M is significant and separately identifiable..

Modifier 59 would only be used if its multiple surgical procedures, there is an NCCI edit between the two and meets criteria for separate reporting.

Thanks! you settled the dispute.