If a code exisits for the service performed then that is the code you select. This is the way it was always explained to me. Why do you say the E&M is never separate? Was the patient scheduled to come in for the procedure? If so I agree no E&M should be charged. However if the evaluation is over above and beyond the evaluation needed just for the procedure then you should have the E&M with the 25 and the procedure with no problem.
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