Results 1 to 4 of 4

Simple repairs (12001 and 17000) & E&M....

  1. Default Simple repairs (12001 and 17000) & E&M....
    Medical Coding Books
    If a pt comes in for a hand wound or warts ect, can you bill the appropriate E&M level with the modifier 57, plus the CPT code for the surgical procedure.

    Say a 99213-57

    Insurance is denying the ov as inclusive, cci edits show it is not mutually exclusive....

    I know what the cpt surgical package states... looking for clarification.

    Sara and Danielle
    coders at our office.

  2. Default repairs (12001 and 17000) & E&M
    If I'm not mistaken the correct modifier to use would be 25 so it would not deny as inclusive. ie 99213-25, 12001, 90471, 90702.

    Hope this helps


  3. #3
    Milwaukee WI
    Default Significantly separate E/M
    Actually the basic evaluation & management of the problem is INCLUDED in the RVUs for the procedure. So unless you have a significant separately identifiable E/M (e.g. also treated HTN or runny nose) I would not code ANY E/M service.

    You wouldn't use the -57 modifier because the procedure is not "major" surgery (90-day global).

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 05-12-2009 at 04:11 PM.

  4. #4
    Urbana, IL
    If the decision for minor surgery was made on the same date then append the -25 modifier to the e/m for minor procedures. The only time the e/m is bundled is if the decision for surgery was made during a previous visit. Check out the AAFP website through Google or your search engine of choice. I would post the link but do not want to go against the AAFP's copyright. Another good place to look is CMS or your local Medicare Carrier's site.
    Dawn Peterson
    Coding Consultant/Billing and Coding Instructor
    Illinois, USA

Similar Threads

  1. Global periods - Simple Lac Repairs
    By amylmor72 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 08-05-2013, 01:33 PM
  2. Cpt 17000 & 11900
    By tholcomb in forum Dermatology
    Replies: 3
    Last Post: 05-10-2013, 08:45 AM
  3. E & M and 17000, 17003 codes
    By Jackie Derm in forum Dermatology
    Replies: 4
    Last Post: 06-15-2012, 01:29 PM
  4. no global days for simple suture repair(12001-12018)
    By maryperry in forum General Surgery
    Replies: 2
    Last Post: 04-06-2011, 03:13 PM
  5. CPT 17000&17003 vs 17000x11
    By mcloonan1 in forum Dermatology
    Replies: 4
    Last Post: 05-06-2010, 03:47 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.