Yes, you are on the right track. Some guidelines:
1) planned procedure--code only the procedure.
2) OV with decision to do procedure---eval and exam requires only the standard pre-procedure work. Code only the procedure
3) OV with decision to do procedure---eval and exam requires more than standard pre-procedure work. Code OV with mod -25 and the procedure
An example to show the difference between # 2 and #3 is ...........
Patient comes in for eval of lesion on right arm. Physician examines and decides he need to do a full body skin exam due to patient's high degree of suntanning. He can code for OV with mod -25 and the lesion removal
Basically there has to be significant separate work perfomed (other than expected pre-procedure work) to support the coding of an E&M with mod -25
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join