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Thread: Anoscopy(flexible fiberoptic) during evaluation and management?

  1. #1

    Question Anoscopy(flexible fiberoptic) during evaluation and management?

    AAPC: Back to School
    Okay... I'm beating my head against the wall here. Hoping anyone out there can help! I am getting two completely different views on this subject everywhere I turn. Here is the scenario:

    Patient presents for a consultation with surgical specialist for Hemorrhoids and Rectal Fistula. The dictation is a FULL evaluation and management visit, and during the exam, "Fiberoptic anoscopy was performed, scar tissue and hypertrophy papilla were seen."

    To bill separate procedure or not? Here is the question: Do you bill a New patient visit(or consult if non medicare) with a modifier -25, and bill the 46600 for the anoscope procedure, OR is this procedure content to the E/M?

    I've had several say it's content to the E/M, and other say no... it's separately identifiable. Any help would be so appreciated!

  2. #2


    As per my opinion Anoscopy procedure could be coded separately along with the consult or new patient visit for the above scenario.

    Jemimah Crescentia,CPC

  3. #3
    Join Date
    Apr 2007
    Tacoma, WA


    I agree...new patient, procedure not previously planned, code the New pt E/M with 25 modifier and then the procedure code.
    Arlene J. Smith, CPC, CEMC, COBGC
    AAPC Tacoma WA Chapter

    President 2015
    Past-President 2013 and 2011
    President-Elect 2010
    Member Relations 2008
    AAPC NAB 2007-2009

  4. #4
    Join Date
    Apr 2007


    Agree with the 25 modifier. But I've never heard of a flexible fiberoptic anoscopy.

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