E/M with injection same day

ladymatthew

Networker
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31
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I work for an orthopedic practice where the physicians see patients and do injections same day all the time. I have been trained to bill the E/M level for the visit and the injection code and append modifier 25 to the E/M level. Recently I went to an E/M workshop and the instructor told me that I have been doing this all wrong and it is not appropriate to even bill the OV with the injection done same day. For example : a New patient comes into the office and is worked up and diagnosed with a trigger finger, the md decides to perform an injection. I would bill 99203 -25 20550- FA (for whichever finger) and then the medications.... but she told me that I should not be billing this way..... but that I should only be billing the injection. Is this true? Can anyone give me insight to this? or forward or direct me to related articles or discussions? thank you so much!
 

Lyta2000

Networker
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72
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Mint Hill, North Carolina
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modifier 25 means " a significant separately identifiable E&M" was done. per the CMS Claims manual the decision to perform the procedure is not enough to substantiate the e& m charge. do some more research.
 
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