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charging Office visit at same time of wound repair

  1. #1
    Smile charging Office visit at same time of wound repair
    Medical Coding Books
    I was wanting to know if it is legal to charge an office visit with a wound repair when the only diagnosis is for the wound repair


  2. Default
    Remember that in order to report and E/M visit with a 25 modifier you need to have a significant, separately identifiable E/M service. Make sure your documentation support this.


  3. Default
    I agree with Monika. Adding to that, I'd personally review the documentation, and if it's supported, bill an E/M with modifier 25 and the wound care.


  4. #4
    Question e/m with a repair
    Thanks for the info. I understand about using the mod 25 with the e/m service, but what the doctor was wanting to do was charge an e/m with a simple repair 12001 and the only diagnosis we had was for the wound, so I didn't think it was right to charge the e/m.

    Kind of confused


  5. Default

    Best way to get unconfused is to get the chart notes, review them and then decide if it's billable or not. Hope that helps.


  6. #6
    Also when using modifier 25,it states different diagnosis are not required for reprting E&M on same date.

  7. Smile Website Info
    Check out this site from EdgeBlast. It kind of helps clarify ( for me anyhow) with some examples of exactly what you are looking at
    Jaime CPC, NCP, EMR Specialist

  8. Default Same issues with simple repains and reporting e&m
    I'm dealing with the same thing. I work in Urgent cares. A patient comes in and says they accidentally cut themselves. The doctor checks them over and all of that and decides they need a simple repair 12001. Would that call for an E&M and the repair code or is the E&M included in the simple repair code? Now if the patient complains of being dizzy, is that an automatic E&M? Does anyone have any good links that explains all the rules on this?

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