tci ED Coding & Reimbursement Alert - 2005 Issue 1

Reader Questions: Include Hernia Work in ED E/M Code

Question: Since there is no code for manual reduction of an inguinal hernia, is it appropriate to append modifier -52 on a surgical procedure code such as 49496 or 49495. Should I only use modifier -52 when the physician eliminates part of the procedure? If -52 isn't correct here, should I just include the procedure in the E/M code?     Texas Subscriber Answer: Your best bet here is to roll the physician's work on the inguinal hernia into the evaluation and management (E/M) code (99281-99285). If he administered parenteral narcotics, that would satisfy the requirement for...

To read the full article, sign in and subscribe to tci ED Coding & Reimbursement Alert.

Thank you for choosing Find-A-Code, please Sign In to remove ads.