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Thread: billing two E&M and procedure code

  1. #1
    Join Date
    Apr 2007
    Loma Linda,CA

    Default billing two E&M and procedure code

    AAPC: Back to School
    Ok so we are billing a 99392, 99213 and 17110.
    I added the modifier 25 to the 99213.
    The billing office is saying we should have modifier 25 on both the 99392 and 99213, I was told by the compliance office I billed correclty.
    Does anyone know which is correct?

  2. #2


    The modifier 25 only will apply to the 99213. Depending on the payor you may need to add modifier 59 to the surgical procedure to distinguish as separately billable/reimbursable.

  3. #3
    Join Date
    Apr 2007
    Loma Linda,CA


    I acually had the modifier 59 on the 17110 and they said that was not correct.
    Thank you for your help.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Does Documentation Support?

    I have no way of knowing if your documentation actually supports both a preventive and a sick visit on the same DOS, as well as treatment ...

    But ...

    Mod 25 on all E/M services performed on the same DOS as a minor procedure.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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