Intial Hosp AND PEG tube placement

TKoehn

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If the Doctor did an initial hospital visit with the patient and then later that day have to put in a PEG tube, would the hospital visit get the modifier since it has a lower allowable?
 

JenReyn99

Guru
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Since the hospital visit is an E/M code, and the PEG placement is an actual procedure code, you need to use the 25, but not because of the level of reimbursement. In this case, the reimbursement isn't the reason for the modifier. You are going to put a 25 on the E/M in order to indicate that the doc had a visit with the pt. on the same date as a procedure.

The higher reimbursement order coding only applies to multiple procedures performed in the same day. Not E/M's and procedures. I hope what I'm saying is making sense, I'm trying to put it clearly, but I'm not so sure I am..lol :0)
 
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