# New ED coder question



## tnt (Apr 15, 2009)

Hi, I understand that when coding for ED physcians I would code appropriate e/m with modifier 25 and appropriate procedure code.(ie e/m-25 with wound repair code)What happens when the nurse performs a procedure (ie n.g. insertion,standing orders or throat cultures,etc.) How and who would code it? Thank You


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## dmaec (Apr 15, 2009)

those types of procedures (well, maybe the insertion might)- don't necessitate the use of modifier .25 on the E/M.  those are "part of the E/M".

(the wound repair would require the use of the .25 mod)...


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## mitchellde (Apr 15, 2009)

When working in the ED you have to remember who you are coding for, if you are the physician coder then the nurse is not your resource and therefore her activity is not billable so no a 25 is not on the physician charge, however if you are coding for the facility then the nurse is your resource and if the procedure is a significant procedure (status S or T), then the facility E&M needs a 25 modifier if if it is performed by the nurse.  I hope that answers the question maybe more than you wanted though!!


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## tnt (Apr 15, 2009)

Thanks, your replies do answer my question. The more info I get the better! Most likely I will be coding for the ER docs not the facility. So I'll be looking for E/Ms,and procedures that the docs performed and not worry about the nurse. Thanks again.


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