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Wiki Otolaryngologist denied office visit

TishCpc

Networker
Messages
40
Location
Dallas, TX
Best answers
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Can I add a modifier 57 to an office visit with a 25 if the dr does a procedure the same day as the office visit.
Example 99214 25
30140, Can I add a 57 to the office visit?
 
That has a 90 day global I believe so it would need a 57 on the E&M. However was this a pre scheduled event? If so you cannot bill an E&M at all. Also you should check to see if this procedure is allowed as a payable service in a POS11.
 
According to the notes on modifiers, "modifier 25 is not used to report an E/M service that resulted in a decision to perform surgery > see modifier 57. For significant, separately identifiable non-E/M services, see modifier 59." Given this rule, I would say that you cannot use both 57 and 25 on the E/M.
 
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