Wiki Billing Compliance and Insurance Coordinator

[NaiSae987]

Hello,
Can someone help me clarify? Can you bill an E&M (without the -25 modifier) with a skin tag removal, code 11200 on the same visit?
Skin tag removal has a 10 day global period, my understanding is that an E&M would not be covered unless there was another issue and we can bill with -25 modifier?
Our office billed an E&M without the -25 with the skin tag removal on same day and got paid. Although, I'm glad we got paid, I also want to ensure that we are following coding rules correctly.
Can someone please advise?
Thank you.
Nai S.

 

[alysn1drlnd]

You are right! Unless there is significantly identifiable reason other than the skin tag removal, you shouldn't bill the EM with modifier. You got paid because the insurance assumed you have documentation to back up the modifier..if it's found in an audit, the practice may not be too happy later!