Wiki Anatomical Modifiers with E/M

[salorn88@aol.com]

I was told that an anatomical modifier was required with diagnosis nail dystrophy of left thumb. But pt was not treated only in for e/m. Can a modifier other than -25 be added to e/m?

 

[CodingKing]

Anatomical modifiers should not be attached to E&M codes, only 10000-79999 series codes.

 

[AlaskanCoder]

The first problem with this information you were given is that HCPCS modifiers are not determined by the diagnosis. The ICD-10 CM for this diagnosis (L60.3) does not have anatomical indicators. If the provider does a debridement (CPT 11720 or 11721) then some payers may want an anatomical indicator, but it is not required by all payers.

Modifiers 24, 25 and 57 are the only Modifiers appropriate for use on E/M for professional coding. Additionally, these modifiers are not appropriate on any procedural codes.

Hope that helps.

Karen
CCS-P, CPC, CPB, CPMA, CPC-I