First, is the established patient visit scheduled specifically for the procedure?
The RVUs for all procedures include appropriate E/M.
However, if the E/M is truly a separately identifiable service ...
If the procedure has a 90-day global you need a -57 modifier on the E/M code. If the procedure has a 10 day or less global period you need a -25 modifier. (I'm at home and don't have all my reference materials, so I don't know if the procedures you cite are major or minor.)
It is pretty much the usual practice for payers to deny the E/M code. I appeal with a letter and the documentation ... that's why you need to be certain that your E/M was truly "significant and separately identifiable."
F Tessa Bartels, CPC, CEMC
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