# Billing Level office visits with Wart Destruction



## Jhollins2 (Jul 18, 2017)

Should a 99211 be bill with 46924 when billing Medicaid?  Should 99212 be bill  with 46900 when billing Medicaid?  Is not the office visit bundle or apart of the destruction of the wart?


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## CodingKing (Jul 18, 2017)

E&M must be significant and separately identifiable from the wart destruction. There is a minor E&M component to all minor surgical procedures with 00/10 day global, such as assessing the warts and choosing destruction method.

NCCI Manual on E&M w/ minor procedure



> If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure. (Osteopathic manipulative therapy and chiropractic manipulative therapy have global periods of 000.) *In general E&M services on the same date of service as the minor surgical procedure are included in the payment for the procedure. The decision to perform a minor surgical procedure is included in the payment for the minor surgical procedure and should not be reported separately as an E&M service.* However, a significant and separately identifiable E&M service unrelated to the decision to perform the minor surgical procedure is separately reportable with modifier 25. The E&M service and minor surgical procedure do not require different diagnoses. If a minor surgical procedure is performed on a new patient, the same rules for reporting E&M services apply. The fact that the patient is “new” to the provider is not sufficient alone to justify reporting an E&M service on the same date of service as a minor surgical procedure. NCCI contains many, but not all, possible edits based on these principles.
> 
> Example: If a physician determines that a new patient with head trauma requires sutures, confirms the allergy and immunization status, obtains informed consent, and performs the repair, an E&M service is not separately reportable. However, if the physician also performs a medically reasonable and necessary full neurological examination, an E&M service may be separately reportable.


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## sldenning (Jul 19, 2017)

*Replying to CodingKing*

Hi, CodingKing  Would you mind telling me where you got your source of information in response to Janelle's question about wart destruction billed with E/M eval?  I need to share information with a provider.


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## Jhollins2 (Jul 19, 2017)

*Thank you*

Thanks for your help CodingKing!!! I would like to know what source did you get the information from I need to share it with a provider.  

Thanks,


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## CodingKing (Jul 19, 2017)

NCCI Manuals can be found in the donloads section on the bottom of the following page. Its not wart specific but I grabbed the above quote from the E&M section.


https://www.cms.gov/Medicare/Coding...ndex.html?redirect=/NationalCorrectCodinitEd/


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## sldenning (Jul 19, 2017)

Thank you CodingKing the information


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