tci E/M Coding Alert - 2021 Issue Q2

Reader Questions: Look to Global for Modifier Success

Question: Notes indicate that after a level-four outpatient E/M service for an established patient, the provider implanted a percutaneous epidural neurostimulator electrode array. Should I append modifier 25 to the E/M code to separate it from the surgery? Indiana Subscriber Answer: In this case, yes. You’ll report 63650 (Percutaneous implantation of neurostimulator electrode array, epidural) for the array implant, and 99214 (Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes...

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