# Wound care clinic, E&M-25 and wound care...is this acceptable?



## Dminman (May 10, 2016)

My apologies if I've posted this in the wrong forum. 

Our providers are beginning to see patients in a wound care center (POS 19). We do not own the center, simply providing the care for the patients. In the office, we do not bill for the E&M if the patient has a debridement on the same day as the visit even if they are a new patient. Does this hold true for a wound care clinic? Is it okay to bill the E&M with a 25 modifier (initial or subsequent)? Any help would be appreciated...


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## CodingKing (May 10, 2016)

Place of service doesn't change how you report these professional services. The only difference is for Medicare and those who base off Medicare, you would be paid off a facility rate instead of the Office/Non facility rate.


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## Dminman (May 10, 2016)

I'm sorry, my question wasn't clear. Am I right with the premise that we are not supposed to bill for a wound care  and an E&M in the same visit unless there was a separately identifiable service for the E&M? And doesn't this rule apply to place of service 19 like it does in the office. I know we can bill the E&M in the hospital setting when doing a debridement, but not in the office.  Thanks so much.


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## kdlepek (May 10, 2016)

*Debridement*

No, you would not bill for E/M services with debridement. Especially for 97598 and 97597. As evaluation and management services of the wound are considered included with these services.


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## tjadams63@outlook.com (Aug 11, 2016)

*Cpc*

If our MD doesn't debride the patient . We do charge an office visit  for the patient. 1 charge for facility and 1 for the MD and we are getting paid when it is filed that way. If he does do a debridement  on established patient then we just charge for debridement unless the patient is new. We then charge for new patient E&M with debridement codes and moldier 25


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## Pam Brooks (Aug 11, 2016)

tjadams63@outlook.com said:


> If our MD doesn't debride the patient . We do charge an office visit  for the patient. 1 charge for facility and 1 for the MD and we are getting paid when it is filed that way. If he does do a debridement  on established patient then we just charge for debridement unless the patient is new. We then charge for new patient E&M with debridement codes and moldier 25[/QUOTE
> 
> You cannot bill an E&M with a minor procedure just because the patient is new.  Per CCI edits 1/1/2016:
> 
> ...


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