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Provider billing E/M with procedure

  1. #11
    Medical Coding Books
    When was the patient last seen, to me it looks like not since 2007. If the patient has not been seen in awhile and this is the first time that the provider has evaluated the wart, the provider would have to do an exam and evaluate the patient and the wart to determin if it should come off. In my opinon I would say per the documentation submitted in the example an E/M with modifer 25 would be approprate.

    If the patient has been seen recently and the wart previously evaluated, but no intervention was taken at the time, than a few weeks later the patient decided they wanted it removed and that is the reason they came in, than I would say no E/M only the procedure.

  2. #12
    i agree, clark100

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