tci E/M Coding Alert - 2024 Issue Q3

You Be the Coder: Does This Case Call for E/M and Immunotherapy Codes?

Question: A patient comes to the office for his allergy shot. He complains of an earache after swimming, so the doctor performs an evaluation and management (E/M) service focused on the otalgia complaint. Can we bill an E/M with a 25 modifier in addition to the immunotherapy injection? South Dakota Subscriber Answer: Allergy testing codes and CPT® codes for allergy immunotherapy injections include the work of a standard E/M service during that same encounter. Because of this, you should not bill a separate E/M office visit code for the time spent talking with the patient about the risks and...

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