Neurology & Pain Management Coding Alert

Question: When we do a mini-mental examination and use code 96115, can we also bill the regular office visit with modifier -25 when the neurologist has done more than the mini-mental?
         
New York Subscriber

 
Answer: The mini-mental status examination, 96115 (neurobehavioral status exam & with interpretation and report, per hour), is included in the E/M visit and is not separately billable. In the past you were able to bill for the E/M visit and the mini-mental with 96115 and modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). However 96115 is now a bundled code.
 
-- "Reader Questions" and "You Be the Coder" answered by Margie S.Vaught, CPC, PCE, CSS-P, MCS-P, an independent consultant in Washington state who serves as technical support for the American Academy of Professional Coders (AAPC); Laureen Jandroep OTR, CPC, CCS-P, CPC-H, owner-consultant of A+ Medical Management & Education in Egg Harbor City, N.J.; Sheldon Schmidt, CPC, billing manager, Badger Billing Services, Mequon, Wis.; Neil A. Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pennsylvania Medical Center at Shadyside in Pittsburgh; Carolyn Dickey, manager, Medical Claims Management, Brookline, Mass.; and Veronica Rigsbys, claims representative, Blue Cross/Blue Shield, Miami.