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99222 -25?

M

marycpc

Contributor
Messages
18
Location
Maywood, IL
If a patient is seen in the hospital for an initial consult and an I&D is done at the same time, do you append a 25 modifier or not bill the consult?

Please advise. Thanks.:o
 
I would say this depends on whether the encounter with the patient was actually a consult or if it was a transfer of care (for the problem)... Say the admitting knew the patient needed the I&D and handed off that medical problem to your provider to perform the procedure, I would say no to billing both... But if the I&D was separate from what was being consulted on or if your provider was the one that made the decision that I&D was the best management course for the medical problem then I say yes, bill both with the modifier 25 on the E/M.
 
my question on this is... who decided the surgery needed to be done? Admitting--then to me its a transfer of care--no E/M. Provider who did the I&D--then yes a E/M is warranted.

Just my two cents.
 
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