Wiki Dermatology CPT Charge 99213

[daguilar@swgiassoc.com]

Can you charge a 99213 for a second visit for a DX of 17110 which is
destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions, up to 14 lesions ? Thought is that you can not charge a second office visit on return of treatment unless the treatment is for
a different DX ?

 

[mitchellde]

if it was preplanned from a prior encounter then you cannot charge another E&M

 

[daguilar@swgiassoc.com]

Thank you, thought so, is there any documentation any where that reflects if it was pre-planned you cannot charge an e/m ?

 

[mitchellde]

the definition of the 25 modifier, which states the EM must be significant ans separately identifiable. If the procedure is preplanned then the E&M cannot be either significant or separately identifiable, since you already know what is to be done and the reason for the procedure.

 

[daguilar@swgiassoc.com]

Thank you again !