Neurology & Pain Management Coding Alert

Don't Leave Out Any E/M If Separately Identifiable

The 62270 and 62272 CPT® codes are considered to be minor surgical procedures in that they both have a zero global surgical day period. "Per Chapter 1 of the Medicare NCCI Manual -- 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," says Marvel Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, owner of MJH Consulting in Denver, Co.

If the patient's condition required a separately identifiable and significant E/M service above and beyond the usual pre- and post-procedure care associated with the lumbar puncture that was performed on the same day, the physician may separately report the appropriate E/M service code, and append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

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