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Wiki 99223 & 96365

K

kadesiag

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If a patient was seen in the office and recv'd 96365 and was admitted to the hospital from the office 99223, what modifier do you use so that the procedures won't be incidental to each other?
 
You would need a modifier 25 on the E&M as there is no global period with the 96365.

If a significant separately identifiable evaluation and management service is performed, the appropriate E & M code should be reported utilizing modifier 25 in addition to the chemotherapy administration or nonchemotherapy injection and infusion service. For an evaluation and management service provided on the same day, a different diagnosis is not required.

Source:
http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf
 
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