# EM with 25 and 31231



## awillis52 (Dec 14, 2011)

Bundling tool shows 99214 bundles with 31231.  Is it appropriate to add 25 modifier?


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## Lujanwj (Dec 15, 2011)

Yes, you can use -25.  However, you need to make sure that you can show Significant, separately identifiable E/M in order to use.  Remember, If a code has a global period there is already some reimbursement for E/M built into the code.  

The way I look at it is, if a patient walked into the office you are not going to just put a scope up their nose.  There has to be some E/M to make sure you actually need a scope and to make sure it's appropriate.  If the E/M is outside of what is needed to do the scope you should be OK to use -25.  With that said, you'll still need to show medical necessity for the extra E/M and you'll need to "carve out"  the E/M for the scope to bill the appropriate E/M Level.


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