Wiki E/M plus procedures

coderjane

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Patient came in for an annual physical but also was treated for allergies and abdominal pain, do I append modifier 25 to the E/M and no modifiers for the procedures or do I add modifier 59 ( distinct procedure)? I understand mod 59 cannot be used with an E/M but these procedures are not normally billed with a preventative E/M. The following codes need to be billed.

99385 np physical
99203 e/m
95004 allergy prick
76700 abd sono
95027 allergy intradermal
36415 venipuncture
81001 ua
 
I would code 25 with both e&m codes, but I would change the OV to an established patient code. In my experience, insurance will only pay for 1 new visit, not 2. I would put 59 on procedures except 36415 and 81001. We are always wary of combining visits like this during well visits just because insurance can be very finicky about what they cover.
 
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