Results 1 to 4 of 4

billing two E&M and procedure code

  1. #1
    Default billing two E&M and procedure code
    Exam Training Packages
    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
    Melbourne, FL
    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
    I acually had the modifier 59 on the 17110 and they said that was not correct.
    Thank you for your help.

  4. #4
    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

Similar Threads

  1. denial ER claim billing an EM code and procedure code
    By kmg745511 in forum Emergency Department
    Replies: 2
    Last Post: 11-09-2014, 09:55 AM
  2. Evaluation & Procedure billing
    By in forum Medicare Regulations
    Replies: 5
    Last Post: 12-09-2013, 11:20 PM
  3. E&M with procedure code
    By Valerie1 in forum Medical Coding General Discussion
    Replies: 10
    Last Post: 01-29-2013, 01:54 PM
  4. E/M & procedure code
    By mrolf in forum E/M
    Replies: 1
    Last Post: 07-06-2010, 07:05 PM
  5. OP Procedure E & M Code
    By srburk in forum E/M
    Replies: 1
    Last Post: 01-26-2009, 01:16 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.