Results 1 to 4 of 4

99222 -25?

  1. #1
    Default 99222 -25?
    Exam Training Packages
    If a patient is seen in the hospital for an initial consult and an I&D is done at the same time, do you append a 25 modifier or not bill the consult?

    Please advise. Thanks.

  2. #2
    Default
    I would say this depends on whether the encounter with the patient was actually a consult or if it was a transfer of care (for the problem)... Say the admitting knew the patient needed the I&D and handed off that medical problem to your provider to perform the procedure, I would say no to billing both... But if the I&D was separate from what was being consulted on or if your provider was the one that made the decision that I&D was the best management course for the medical problem then I say yes, bill both with the modifier 25 on the E/M.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  3. #3
    Default
    It was my take on this that the E & M that results in the decision to perform the surgery/procedure is always billable?

  4. #4
    Default
    my question on this is... who decided the surgery needed to be done? Admitting--then to me its a transfer of care--no E/M. Provider who did the I&D--then yes a E/M is warranted.

    Just my two cents.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

Similar Threads

  1. 99222 vs 99305
    By nkorab in forum E/M
    Replies: 0
    Last Post: 01-28-2015, 12:34 PM
  2. 99222 during global period
    By pnepooh in forum Orthopaedics
    Replies: 1
    Last Post: 09-04-2014, 04:00 PM
  3. 99222 vs 99223...what's missing ?
    By bill2doc in forum E/M
    Replies: 3
    Last Post: 11-02-2012, 02:02 PM
  4. 99222 and 99215
    By Chandru.E in forum Emergency Department
    Replies: 2
    Last Post: 10-13-2010, 08:40 AM
  5. 99436 and 99222
    By cedwards in forum OB/GYN
    Replies: 3
    Last Post: 09-01-2009, 10:37 AM

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?

Login

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.