tci E/M Coding Alert - 2013 Issue 10

Reader Question: Modifier 25 Trumps 59

Question: Our payer is denying a claim involving an E/M and a fine needle aspiration (FNA) of a bone lesion with modifier 59 for an improper modifier. Is my modifier use appropriate?California Subscriber Answer: Most payers, including Medicare carriers, require modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service) on an E/M service reported with a minor procedure, such as an FNA of a bone lesion. You should consider procedures with a 0- or 10-day global period as minor...

To read the full article, sign in and subscribe to tci E/M Coding Alert.


Stay informed, get answers to your E/M coding and documentation questions, and find the help you need to bank your deserved pay with your subscription to TCI’s E/M Coding Alert.

  • Current newsletters added each month
  • Fully searchable archives - over 500 articles
  • ALL years/issues back to 2013 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci E/M Coding Alert +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

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