tci ED Coding & Reimbursement Alert - 2024 Issue Q1

You Be the Coder: Separate E/M With Minor Procedure

Question: A patient reports to the ED with an ingrown toenail. During the exam, the physician notices that the patient also has an infected foot wound and administers an intravenous antibiotic. In this scenario, in addition to the appropriate code for the toenail excision, can you report a separate and significant evaluation and management (E/M) service for the unrelated infected foot wound using modifier 25 along with the appropriate E/M code? West Virginia Subscriber Answer: Yes, you can use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on...

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