Results 1 to 2 of 2


  1. #1
    Default Help ASAP
    Medical Coding Books
    If an ARNP who works in an office with the provider who is going to perform a procedure and the ARNP see the patient for an E/M and bills under her number does she still have to append Modifier 25 to her visit or is this only if she bills "incident to" the provider?

    Thanks so much always for your help.

  2. #2
    Milwaukee WI
    Default Nothing to do with incident to
    If I understand the scenario correctly, this service has nothing to do with "incident to."

    You state that the provider who is going to perform a procedure . This indicates to me that the reason for the visit is the procedure. The reimbursement for the procedure includes the pre- and post-operative evaluation/management necessary for that procedure. So it cannot be billed whether performed by the physician him/herself or by the PA or NP working in that same office.

    For example, patient scheduled for colonoscopy. NP does the pre-procedural E/M before gastroenterologist performs procedure. NO separately billable E/M.

    On the other hand. Patient scheduled for lesion removal on right forearm. However, patient arrives with complaint of rash on chest. NP evaluates and treats for rash. This is a significant and completely separately identifiable E/M performed on the same day as the procedure. You would code the E/M (under the NPs name/number) with a -25 modifier.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. help ASAP please
    By eadun2000 in forum Medical Coding General Discussion
    Replies: 13
    Last Post: 02-21-2014, 12:21 AM
  2. Please help ASAP!
    By JAB86 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 10-14-2011, 08:47 AM
  3. Asap!!!!!!
    By charonate in forum E/M
    Replies: 2
    Last Post: 09-22-2011, 02:44 PM
  4. Need Help ASAP-Please!
    By dballard2004 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 09-20-2011, 07:27 AM
  5. Please help asap if at all possible
    By broundy in forum Cardiology
    Replies: 2
    Last Post: 08-20-2010, 09:19 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?


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.