tci General Surgery Coding Alert - 2019 Issue Q3

Reader Question: Master Modifier 25 Tips

Question: Our surgeon saw an established patient in the office to examine a third-degree burn on the right calf. The surgeon determined that the tight burn surface was impacting circulation and required an escharotomy, which he performed. Can we report an E/M and the escharotomy, and should we use modifier 57 since the visit included a decision for surgery? Texas Subscriber Answer: You can separately report both the E/M and the escharotomy, but you should not use modifier 57 (Decision for surgery). Do this: Code the escharotomy as 16035 (Escharotomy; initial incision). Also report the office visit, using a...

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