natela
New
If the specialty doctor did consultation in the hospital 99233, and also did aspiration of hematoma cpt 10160, can we bill those 2 codes with modifier 25? We are billing professional charges. Thank you!
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Wiki Billing aspiration with E/M inpatient code
- Thread starter natela
- Start date
Pam Warren
True Blue
I'm assuming that these were done on the same day. Generally, an E&M service is bundled into a minor procedure (per NCCI), but if the E&M is significant and separately identifiable from the pre-, intra-, and post procedural work for the aspiration, you can bill both. There is always going to be some level of patient evaluation of the hematoma site, some history taking, exam components, and then the actual aspiration work. If your provider can show that much more was done and documented beyond that which is generally done with any other hematoma aspiration, then you can bill separately based on MDM or time (which excludes the procedural time). Otherwise, it's all bundled into the aspiration.