tci ED Coding & Reimbursement Alert - 2024 Issue Q2

Reader Questions: Make Modifiers Work for You on Lesion Removal

Question: After a level-three ED evaluation and management (E/M) service, the physician shaves a pair of dermal lesions: one 2.1 cm lesion from the left hand and a 1.2 cm lesion from the left arm. Do I need a modifier to report this encounter? AAPC Forum Subscriber Answer: You won’t need a modifier — you’ll need four. On the claim, report: 99283 (Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making) for the E/M Modifier 25 (Significant, separately...

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