adunlap23
Guru
I am new to E/M coding and have a pretty basic question.
The patient was initially seen for Right shoulder pain, and an MRI was ordered during (this was the previous visit).
The patient has now returned for a follow-up where the doctor reviews the MRI (performed at another hospital) and discusses the findings of the report. He diagnosis the patient with Calcific tendinitis and gives the patient an injection in the shoulder to treat the problem. He also refers the patient to Physical therapy with a brief plan of increased function, pain relief, activities of daily function and education.
My question is, do the MRI interpretation and physical therapy referral count as "significant and beyond the normal preoperative and postoperative work", thereby qualifying the E/M code to be billed with modifier 25? Or do they qualify as services typically associated with the 20610 procedure?
I've seen a few fact sheets on the appropriate use of modifier 25, but I've never really found out what the terms "significant and beyond normal preoperative and postoperative work" means.
The patient was initially seen for Right shoulder pain, and an MRI was ordered during (this was the previous visit).
The patient has now returned for a follow-up where the doctor reviews the MRI (performed at another hospital) and discusses the findings of the report. He diagnosis the patient with Calcific tendinitis and gives the patient an injection in the shoulder to treat the problem. He also refers the patient to Physical therapy with a brief plan of increased function, pain relief, activities of daily function and education.
My question is, do the MRI interpretation and physical therapy referral count as "significant and beyond the normal preoperative and postoperative work", thereby qualifying the E/M code to be billed with modifier 25? Or do they qualify as services typically associated with the 20610 procedure?
I've seen a few fact sheets on the appropriate use of modifier 25, but I've never really found out what the terms "significant and beyond normal preoperative and postoperative work" means.
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