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Wiki Office Visit & SX

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Hopp

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Please help me coding following: New pt presents to office
with infected cyst back. Doc schedules him same day for
sx @ hospital. ? being. - Can I code both the OV and Sx?
If so do I just append ov with 57 modifier or do I use both
57 and 25 TIA for any advice
Deb, CPC
 
Hi!

If the decision to do the surgery was made during the E/M (which is what this sounds like) then you would bill the E/M and the surgery. You would use only the -25 or the -57, not both and the choice would depend on the procedure the doctor is performing and the global period. If the procedure has a global period of 0-15 days, then you would use -25. If the global period is 90 days, then use -57.

Hope this helps! :)

Jodi Dibble, CPC
 
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