# E/M and procedures



## mpblanch (Aug 7, 2009)

When an E/M and a procedure are performed on the same day(yes, a separately, identifiable E/M is performed ) We post the E/M as the first charge and then the procedures after that.  Does anyone have any written documentation that supports this is correct coding?  Thanks in advance for your help! 
Maria


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## LLovett (Aug 7, 2009)

This was asked previously and there was never a written source posted.

https://www.aapc.com/memberarea/forums/showthread.php?t=15693&highlight=code+order

I don't have a written source but we have always coded in RVU order as the other poster stated they did.

Hopefully someone will have some back up to post this time.

Laura, CPC, CEMC


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## Connie Ruiz (Aug 11, 2009)

*E/M and procedure*

I kind of have the same problem on trying to bill a visit and a procedure.  I have been told that we can not bill an E/M visit along with a procedure such as a Endometrial Bx on the same date we either bill the E/M or the procedure.  If we use a modifier and our documentation states that the decision to do the procedure was due to the E/M visit is there not a modifier that can be added to support the billing of both.


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## mpblanch (Aug 13, 2009)

Connie- If the pt was scheduled to come in for the endometrial bx, then an E/M should not be charged on the same day.  The reason for this is that every procedure has an element of E/M included with it.  However, if the pt came in, was evaluated and then the decision for the biopsy was made at that visit and performed on the same day, then modifier 25 would be appropriate to bill.    I hope that helps you. 

My question is looking for supporting documentation that states to bill the E/M first, and then the procedure(s) performed on the same day after the E/M.


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## FTessaBartels (Aug 13, 2009)

*Highest RVU value first*

We always code the highest RVU value first, whether multiple procedures, or procedure and E/M. 

F Tessa Bartels, CPC, CEMC


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