Okay, so -25 shows that the office visit was ABOVE and BEYOND than what a "typical" office visit is for. The lesion scenario, I can totally see what she is saying in that the patient goes in for lesions, gets and I&D, and leaves the office. Say you bill a 99213-- yes, the visit was done and during the visit, a decision to go ahead and treat the leasion was made. MDM was rather low at that point since it was able to made right then and there. Provider also performs the I&D and yes, that is also able to billed. HOWEVER, I see no place for a -25 modifier because the office visit itself was FOR the lesions. Period.
IF...the patient went in and had lesions checked out, and DURING the visit, says, "doc, hey, I got these really bad warts on my feet too-- mind taking a look at them while Im here?" THAT is when 25 can be reported. Because the original office visit for the lesions no longer was JUST for the lesions-- the doc also inspected Patient X's feet. In turn, he can bill with a -25 modifier in order to receive correct reimbursement for BOTH types of service offered in ONE office visit.
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