stannler
Contributor
I have returned to coding after being out of the field for 2 years. I work for an ENT practice. This may be a very basic question, but I need some clarification. A NEW patient is referred to us for a hematoma of the ear. There is some confusion on whether we can bill an E&M (99202) AND drainage of hematoma (69005) because this is a NEW patient. The only complaint addressed in the visit is the ear. My understanding is that in this case, we would only bill the office procedure, 69005, as this procedure would inherently include E&M. Is this correct? Does the fact that it is NEW vs EST patient have any bearing on the scenario? Also, I assume IF we can bill both, we would use a modifier 25 with the E&M. Also, if anyone can direct me to the specific guideline/source, , I would greatly appreciate it. Thank you! Sean