Question: Results are negative. Notes indicate a level-four E/M. Can I report 30903 x 2, since the physician stopped bleeding in both nostrils? Tennessee Subscriber Answer: • 30903 (Control nasal hemorrhage, anterior, complex [ extensive cautery and/or packing] and method) for the repair • modifier 50 (Bilateral procedure) appended to 30903 to show that the physician treated both nostrils • 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of moderate complexity ...) for the E/M • modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) appended to 99284 to show that the E/M and repair were separate services • 784.7 (Epistaxis) appended to 30903 and 99284 to represent the patient's nosebleed • E917.0 (Striking against or struck accidentally by objects or persons; in sports without subsequent fall) appended to 30903 and 99284 to represent the cause of the patient's nosebleed. • E007.5 (Activities involving other sports and athletics played as a team or group; soccer) appended to 30903 and 99284 to represent the circumstances surrounding the patient's nosebleed.