Agree with Marissa above, to be sure.
This is a loaded issue, as many payors, starting with CMS, have tried for years to argue that there is enough overlap in work between the E&M associated with the visit and the work of the injection that they should somehow be bundled. That is entirely inappropriate. CPT has established, as has CMS, what E&M work is associated with the injection itself - it includes the decision to move forward with the injection, the discussion of risks/benefits and the discussion of post-procedure care. That's it. The work of the injection DOES NOT include the evaluation of the patient, consideration of alternative diagnoses, consideration of alternative treatments, etc. IF that work is being done, and being documented, that is a separate and identifiable E&M service, per CPT. That needs to be broken out with a -25 modifier.
-25 Modifiers have had a target on their back for years, stemming from a 2018 CMS PFS Proposed Rule that was NOT finalized. Several third party payors have taken that proposed rule (which, to be clear, is NOT CMS POLICY, it was a proposed-and-rejected policy) as justification for trying to deny E&M on the same day as an injection. If that is happening, as long as the E&M is well documented, it should be appealed fervently. If any coders out there are allowing these claims to be rejected, you are going against established CMS and CPT policy and doing your physicians a grave disservice. Persistent denials of -25 modifier associated E&M should be brought to your state's insurance board.
You should NEVER choose between billing out an injection OR an E&M if they are both documented. They should both be billed, and they should both be paid. Anything less violates CPT and CMS policy and claims standards.