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E/M coding

  1. #1
    Default E/M coding
    Medical Coding Books
    I have a couple of ?'s. If a routine physical is done and the physician finds a new problem and sends pt. for an u/s can I charge a regular E/M with a 25 on it?

    And.. excision is done, but physician documents enough to qualify for an E/M can you charge for that. The excision was a pre planned appt. Thank you everyone.

  2. #2
    Default
    Based on information provided... no additional evaluation and management service is supported.

    Case One: "If a routine physical is done and the physician finds a new problem and sends pt. for an u/s can I charge a regular E/M with a 25 on it?"
    If the ultrasound findings result in an additional visit where there will be further evaluation and then management of the finding, the provider would bill for the additional visit, typically a different date.

    Case Two: "excision is done, but physician documents enough to qualify for an E/M can you charge for that. The excision was a pre planned appt."
    The decision for the excision is made at a previous visit, the only medically necessary evaluation and management service is to verify that the patient is still medically stable for the procedure and is not separately billable.
    Mickie Kummer, CPC, CPMA, CRC, CPC-I, AAPC Fellow

  3. #3
    Location
    Lauderdale Lakes
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    203
    Default
    I have to disagree on case one. If the physician performs a physical and finds a problem and addresses the problem then yes you can bill the ov with a 25 modifier. Make sure he did address the problem and their is enough info to bill the ov.

  4. #4
    Default
    thank you

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