Wiki Modifier 25

[tpayne129]

If a patient has a pre-scheduled minor procedure in office (an injection) (the procedure was finished, all post op work is completed) then the doctor discusses the patient's opioid prescription plan with them and refills their prescription, can I bill the minor surgery with an office visit code with a modifier 25 or would that fall within post service components? The doctor thinks we should be able to but I think it is risky. I also don't see how to separate the notes to make it "separate and distinct".

Can anyone give me more clarification?

 

[Evelyn Kim]

I wouldn't unless the docuemtation is very clear. Because it is a prescheduled procedure an office visit is not going to be separately payable.