We had a 12 year old child present for preventive visit but also complaints of acne, warts and a chest problem. In addition to the preventive visit history and exam, the doctor diagnosed pectus carinatum, acne and warts, discussed the pectus carinatum and acne problem, wrote a rx for acne and removed the warts with cryosurgey. The physican wanted to charge the prevent as well as a level 2 e/m and the wart removal procedure, which we did attaching the -25 modifier to the level two visit. Insurance paid for the level 2 E/m and wart removal but not the preventive medicine code, stating "payment included in allowance for other service/procedure." Should we have used a different modifier because of the additional procedure done in order to get all services and procedures paid for? We normally have no problem getting both a preventive and problem visit paid for on the same visit so wondering if the procedure is what caused this preventive service to be "bundled" Any help would be appreciated!! THX!