Admission E&M & Procedure same day

Hopp

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Just wondering how to code for an admission and procedure on the same day?
Example: 99223 25? or 57? or both and Hernia repair I think thats a 49505 don't have my CPT book with me. I tried just using the 57 on the 99223 but did not get paid for the admission code. Also, is there a manual for CCI edits? Thanks for any help. Cricket/Hopp:)
 
Last edited:

mjewett

Guru
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Modifer 57 would be correct, not 25, but most carriers won't pay for the E/M if it was performed within two days of the surgery. If the E/M was two days or more prior to the surgery and at the time of the E/M the doctor decided the pt. would require surgery. Then you would bill E/M mod 57.

Hope this helps.
Melissa
 
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