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Office Visit & SX

  1. #1
    Default Office Visit & SX
    Medical Coding Books
    Please help me coding following: New pt presents to office
    with infected cyst back. Doc schedules him same day for
    sx @ hospital. ? being. - Can I code both the OV and Sx?
    If so do I just append ov with 57 modifier or do I use both
    57 and 25 TIA for any advice
    Deb, CPC

  2. #2
    Daytona Beach, FL

    If the decision to do the surgery was made during the E/M (which is what this sounds like) then you would bill the E/M and the surgery. You would use only the -25 or the -57, not both and the choice would depend on the procedure the doctor is performing and the global period. If the procedure has a global period of 0-15 days, then you would use -25. If the global period is 90 days, then use -57.

    Hope this helps!

    Jodi Dibble, CPC

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