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Quick Question

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andreabukur83

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Woodland Park , CO
Quick question. When a established patient comes in for strictly wart removal. Is it common practice to add an Office Visit in addition to the procedure since it's the first time they are being evaluated/treated for the wart?
 
If the established patient is just coming in for a wart removal, then you should bill the associated procedure code instead. Any procedure has a small E/M bundled into the code. You should only bill an E/M with the procedure, if the E/M has a significant AND separate problem from the wart removal (M25). Doesn't matter if the wart problem is new.

Here is some reading:

Modifier 25 - Noridian (my local MAC)
M25 - AAP
Modifier 25 - ACC

Hope this helps!
 
Pathos said:
If the established patient is just coming in for a wart removal, then you should bill the associated procedure code instead. Any procedure has a small E/M bundled into the code. You should only bill an E/M with the procedure, if the E/M has a significant AND separate problem from the wart removal (M25). Doesn't matter if the wart problem is new.

Here is some reading:

Modifier 25 - Noridian (my local MAC)
M25 - AAP
Modifier 25 - ACC

Hope this helps!
Click to expand...

That's exactly what I thought but I was having a hard time finding exact verbiage for this scenario, so thank you very much!! I'm only 8 months in with my first job, so I wanted to make sure I was on the right track.
 
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