Wiki Same day office visit and milia

[julielsemmler@yahoo.com]

Can someone please reply to my post. I have been waiting for a week to send this claim. Is the correct code for milia, L72.0 or L72.8? Also I had a pt. come into the Dr.'s office twice in one day. Once in the morning for one diagnosis and then returned later in the afternoon for a completely different diagnosis. No treatment was performed on the second visit. Is there a modifier or another CPT code to use for this 2nd visit?

 

[danskangel313]

Milia is classified as an epidermal cyst, L72.0.

As for the patient with 2 visits - "For all evaluation and management (E/M) encounters, except where specifically noted, carriers may not pay for multiple E/M office visits billed by a physician (or a physician from the same group practice) for the same beneficiary on the same day. All documentation for E/M services for the day are combined to determine one E/M code for the date of service."

I also found another set of guidelines that state: "If both E/M encounters are for, or related to, the same condition, documentation for both services would be considered to assign only one E/M code for that day. However, if the second encounter was for unrelated condition, you would report both services using E/M codes and add modifier -25 to the second E/M code."