E & M and 17000, 17003 codes

Jackie Derm

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The doctor saw a new patient and then did the 17000, 17003 procedure. The office visit was for more than just the destructions so we modified it with a 25 modifier. The office visit was denied. Does this need to be appealed to be paid or is there a coding guideline where this cannot be billed together? The patient has Medicare. Thanks.
 

grth97

Networker
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40
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You can bill them together. Just send the notes with the appeal to show that there was a significant and separately identifiable evaluation done on the patient.
 

Susan

Expert
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Chandler, AZ
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The doctor saw a new patient and then did the 17000, 17003 procedure. The office visit was for more than just the destructions so we modified it with a 25 modifier. The office visit was denied. Does this need to be appealed to be paid or is there a coding guideline where this cannot be billed together? The patient has Medicare. Thanks.
You can appeal, but Medicare does not pay for a office visit and minor procedure in the same visit. If your documentation can show that there was something else going on that can stand alone of the procedure will you have a possibility of getting it overturned.
 

grth97

Networker
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Maybe it depends on which contractor?? We have WPS and we get paid all the time when we bill 992_ _ (E/M), 25 with 17000 and any other minor procedure for that matter.
 
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