Wiki e/m plus procedure billing

[EHCS]

Quick Question about billing for e/m services along with procedure codes. It is standard practice for our provider to always do a 14 pt ROS and a full exam as well as the typical temp, bp/vitals upon admission. This is a small urgent care facility. For some reason it still is a grey area for me on billing for the e/m visits as well as the procedure codes. We have always billed the appropriate e/m code with the mod 25 plus the procedure code since he does a full exam plus 14 pt ros. We generally will not look at anything that is directly related to the procedure when looking at the level of e/m to use. for instance if they came in for a finger laceration and medication is prescribed (ie: antibiotic) directly related to that finger laceration then we won't include that or the part of the exam that was directly related to the finger laceration (ie: extremities) after we remove those things then we will assign the appropriate level of E/M service beyond that.

Is this the appropriate way of doing this? I have questioned it in the past and would like some clarification or second opinions on this. sometimes the provider will find other things "wrong" after doing the full exam but usually everything looks good accept for the reason they came in. Obviously if there is additional diagnosis codes beyond the main finger laceration (or whatever) then the additional e/m code should be appropriate...I guess I just question it if the full exam is done and nothing else is found it get confusing to me.

Thanks you in advance for your help, i'm new to the forum and appreciate the assistance. Thanks!