General Surgery Coding Alert

Question: Can I charge for a 99213 and a 17250 on the same day at the same visit if I add modifier 25? The procedure was not scheduled prior to the office visit. Texas Subscriber Answer: If your physicians documentation supports a significant, separately identifiable E/M service, you can report 99213 (Office or other outpatient visit for the evaluation and management of an established patient &) and 17250 (Chemical cauterization of granulation tissue [proud flesh, sinus or fistula]). Append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to 99213 to indicate that there was a separate E/M service. Caution: Do not add a 25 modifier just because the procedure was not scheduled prior to the visit. If the E/M service your physician performed is only the minor E/M associated with the procedure, you cannot add [...]