tci E/M Coding Alert - 2020 Issue Q3

Reader Questions: Modify Your Answer to This Preventive Bundling Question

Question: The patient underwent 99395 25, 81000, 58301-59, 99406 on the same day. How should I bill these codes? Oregon Subscriber Answer: You don’t need modifier 59 (Distinct procedural service) with 58301 (Removal of intrauterine device (IUD)). No bundling exists between any of these codes, so you should report: 99395-25 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years; Significant, separately identifiable evaluation and management service by the same physician or other qualified...

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