E&M and same day US


Portland, OR local
Best answers

I work in a vascular clinic, we have our own ultrasound equipment and US tech and usually our patients will have their US first and then their appt with the doc right after and this is relatively new for me. Ive been told that I cant submit one without the other. I know that modifier 25 needs to go on the E&M but does it all really have to be billed at the exact same time as long as the modifier is on the E&M?

I ask because I have one doc that is MONTHS behind in his E&M billing but his US are read and ready to drop....I would love to be able to drop the US charge and add the modifier to the E&M when its done....

Does anyone know and if so, can you tell me where I can find this rule so I can give it to my "slacker" :)

Cardiovascular Coder

Hi Dfeldt

I work for a small group of cardiovascular specialists and we also have the one physician who rarely submits his E/M charges...he's the head guy! lol...According to my compliance manager we bill his CTA/CT/US with modifier 25 and will bill the E/M charge when received. I hope this helps...Good Luck

Yvonne B
Hi Yvonne,

Thank you for your response. I hate gray areas! I was told modifier 25 on the E/M and not on the US...I wonder if that is when they are sent at the same time....keeping in mind i was also told by the same person that they could never go out separate if they were done on the same day and I dont think thats the case.
Thank you so much for your help!