tci ED Coding & Reimbursement Alert - 1999 Issue 3

Modifier 25 Continued: Billing an E/M visit and a Starred Surgical Procedure

In the February issue of ECA (pages 9-10), we covered billing for an evaluation and management (E/M) service and a procedure performed on the same day by using the -25 modifier (significant, separately identifiable service performed by the same physician on the same day).In most cases, if a patient presents to the emergency department with a complaint, the ED physician performs an evaluation, determines the course of treatment, and then treats the patient for the complaint. For example, a child falls from a playground jungle- gym and is brought to the emergency department, where the physician on duty...

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