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Appropriate modifier use with E/M and X-rays

  1. #1
    Location
    Woodland Hills, CA
    Posts
    121
    Question Appropriate modifier use with E/M and X-rays
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    Hi all, any suggestion will be appreciated.

    I have this case where a new pt came in for the pain within the arm. Doctor performed the Hx, PE and MDM and also has the following note:

    "X-Rays of right elbow (73080), forearm (73090), wrist (73110),
    hand (73130) are negative, PA, lateral and oblique, for any bony abnormalities".

    My question is, if I code this case scenario as 99201-99214 (E/M based on what was documented) with 73080, 73090, 73110, 73130, what kind of modifier I need? Or do I even need one? I assume (I did confirm this with the doctor's office) that the dr did the x-ray in his office and read the results.

    Thanks anyone who will answer to my question.
    Last edited by HCCCoder; 12-19-2008 at 01:24 PM.
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  2. Wink
    First Rule of coding: If it wasn't documented it wasn't done
    Second Rule of Coding: Never Assume Anything!

  3. #3
    Location
    Woodland Hills, CA
    Posts
    121
    Default
    Thank you for your response and I am well aware of those rules.
    Ok, what do you mean "if it wasn't documented, it wasn't done?"
    That's not my question.
    And regarding the x-ray, I did confirm with the doctor and he did that in the office.
    Can you please answer to my question now?

    Thank you,
    Lilit

  4. Default Modifier
    You do not need a modifier with the visit, if all x-rays were done in MD's office.
    Am I correct guys?

  5. Default
    I believe that you would at least need modifier -25 on the E/M service to show that the E/M service was a separate, distinct service. Other than that, I don't think you need modifiers other than directional ones (-RT) on all the X-rays.

  6. #6
    Location
    Woodland Hills, CA
    Posts
    121
    Default
    Thank you very much for all your responses.
    I do need some additional information regarding this. Like any supplemental web sites.
    Is there someone who can help?
    Thank you,
    Lilit
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  7. #7
    Default
    You don't need a modifier on the visit if you are billing only x-rays in addition to the E/M. I would agree with the RT or LT on the x-rays though.

    Happy Holidays!
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

  8. #8
    Location
    Woodland Hills, CA
    Posts
    121
    Default
    Thank you very much I appreciate your time.
    Lilit

    Happy holiday season to you too!
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

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