If the problem encountered is trivial/insignificant/briefly addressed, it's not separately reported. If it IS significant and separately identifiable (as in, would qualify for at least a 99212 on its own), then it can be reported separately with a 25 modifier. (Important! The modifier goes on the problem E/M, not the preventive). Most carriers will only reimburse the problem E/M at 50% of the allowable, though, if billed in the same encounter as the preventive, so be prepared for that. The documentation should make it obvious that the doctor exerted a noticable effort in addressing the problem, and not just a casual mention of its existence.
- 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