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Wiki physical w/procedure help

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If a patient is coming in for a physical wether it be HMO,PPO or Medicare. Should I use a modifier 25 if they also have a procedure like 17000/AK removal? Those codes 99391-99397 and G0438,G0439 are for "Physicals". Are they considered E/M also? Or should I leave the modifier off? Thank you
 
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