tci E/M Coding Alert - 2020 Issue Q4

Reader Question: Can You Report E/M With Cauterization Services?

Question: Is it possible to bill a separate evaluation and management (E/M) service for a patient returning several times for umbilical cauterization? Texas Subscriber Answer: There are no National Correct Coding Initiative (NCCI) edits prohibiting you from doing so. However, your physician’s documentation will have to support a significant, separately identifiable E/M service, in order to report a code from 99201-99215 (Office or other outpatient visit for the evaluation and management of a new/ established patient …) along with 17250 (Chemical cauterization of granulation tissue (ie, proud flesh)). In other words, if the E/M service your physician...

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