tci General Surgery Coding Alert - 2009 Issue 9

Reader Questions: Overusing Modifier 25 Will Cost You

Question: Can I charge for a 99213 and a 17250 on the same day at the same visit if I add modifier 25? The procedure was not scheduled prior to the office visit. Texas Subscriber Answer: If your physicians documentation supports a significant, separately identifiable E/M service, you can report 99213 (Office or other outpatient visit for the evaluation and management of an established patient &) and 17250 (Chemical cauterization of granulation tissue [proud flesh, sinus or fistula]). Append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the...

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