Wiki Billing 46600 with E&M

[sherrm12]

Is there a way to get paid for both the E&M (initial or established) with a 46600? Do we need to use a modifier on the E&M?

 

[fltbaroque]

Was the anoscopy the sole reason for the visit? If so, then bill only the anoscopy. If a full E/M visit was performed, with a reason other than that for the anosocopy, then you can use a 25 modifier on the E/M visit.

Tobi Downs, CPC, CGIC

 

[Codecracker]

Billing E/M visit with 46600

I have found that even with the modifier 25 the insurance carrier (BCBS) is still denying payment based on lumping the E/M visit with the procedure code. All i can do is suggest that you appeal them.