Wiki 82962?..if with E/M modifier?

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Brandy0618

Brandy0618

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This is crazy. I posted this in Path and Lab but apparently either everyone already knows the answer or the opposite (no one knows)...hummm. Our pediatrician completed an E/M in addition to 82962 glucose stick and my question is that I do not think this would warrant a modifier but it is another service in addition to the E/M. Modifier 25 (ending sentence) states "on the same day of the procedure or other service." Please advise, Thank you so much, Brandy (CPC)
 
Was the E&M a separate and Identifilably different encounter or was the E&M for the Glucose stick? If it was for the stick then it might come back from the payer as bundled with the E&M.
 
The child came in for abdominal pain. The child had visited the ER the day before. A CBC was ordered in which it showed an elevated glucose level. Mom was the one that wanted the glucose level checked during her appointment for the abdominal pain.
 
Then I don't see why you can't use both.

Just clarifying a question I just thought of, was the CBC done at the ED visit or the next day when mom asked? Or did mom ask for a stick to verify the CBC?
 
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The ER completed the CBC. The mom requested the glucose stick during the appointment for the abdominal pain. Thank you for replying.
 
Mom took the child to the ER for abdominal pain. During the ER visit the Dr ordered a CBC which reflected an elevated glucose level. Mom scheduled with our Dr (her PCP pediatrician) because mom was concerned about the glucose elevation as family members have diabetes. The primary reason mom scheduled the appointment was to follow up with abdominal pain, but also ask questions about the CBC. Our Dr ordered the glucose stick during her follow up to ck levels again. Thank you so much!!
 
Per our Dr just now, mom had lots of questions about the CBC, so our Dr ordered the stick again to answer more questions. Thank you. You have asked me so great questions to make me re-think this all.
 
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