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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