tci E/M Coding Alert - 2021 Issue Q3

You Be the Coder: Look to This Code Range for Contraceptive Counseling

Question: If a patient comes in for family planning counseling, and our pediatrician administers a Depo-Provera shot at the end of the encounter, can we bill 99403 with modifier 25 along with the shot and the administration? Wisconsin Subscriber Answer: Yes, though you may not need to use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) on the preventive medicine evaluation and management (E/M) service. Assuming the only service your provider provided to the patient in the encounter...

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