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tci E/M Coding Alert - 2013 Issue 3

Reader Question: Say Yes to Time-Based E/M Plus Preventive E/M Coding

Question: Can we use time to select a second E/M code even if the other service code isn’t time-based? Florida Subscriber Answer: Yes. You may use time as the key factor for reporting an E/M code appended with 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). Catch: Counseling and/or coordination of care must constitute more than 50 percent of the face-to-face time the pediatrician spends addressing the problem. Example: A mother brings her 9-year-old son in for...

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