modifier 25

[newfiegirl]

When a patient is scheduled for a procedure ;ie I & D of a cyst and during the visit has complaints of cough, cold, etc, does that then turn into an office visit for bronchitisis with the 25 modifier added for the I & D? My providers will typically do this rather than reschedule the patient. Thanks for any clarification I can get.

 

[Pathos]

When a patient is scheduled for a procedure ;ie I & D of a cyst and during the visit has complaints of cough, cold, etc, does that then turn into an office visit for bronchitisis with the 25 modifier added for the I & D? My providers will typically do this rather than reschedule the patient. Thanks for any clarification I can get.

If the cough, cold, etc. complaints are new to the patient, then a modifier 25 could be appropriate, if documentation otherwise supports both codes.

Sources:

CMS MLN
Noridian
Novitas
Palmetto GBA
MODA

 

[CodingKing]

This meets the definition of unrelated E&M, no questions asked.