Wiki office visit / EMG same day AM/PM

[MTrujillo]

Hello all, I am trying to find out if a mid level provider can see a patient in the morning then that same patient returns at the end of the day for a EMG with a different provider. Can anyone verify if both of these visits are billable by themselves as is??? Or, should the schedulers had put the visits back to back? Thank you for any suggestions given. Mysti

 

[dwaldman]

https://www.aanem.org/getmedia/e880...tement-E-and-M-with-Same-Day-Testing.pdf.aspx

Above is interesting link

In the past when patient was scheduled for EMG, we were only billing the EMG and the physicial exam/history/EMG diagnostic impression was considered inclusive.

CMS would require reference to NCCI policy manual regarding criteria for modifier 25. I believe their explanation of modifier 25 and when it is appropriate would be a more important consideration then if the visit/EMG are back to back or later in the day

https://www.cms.gov/Medicare/Coding...ndex.html?redirect=/NationalCorrectCodinitEd/

Below is from the general correct coding policies of the NCCI policy mnaul

Procedures with a global surgery indicator of “XXX” are not covered by these rules. Many of these “XXX” procedures are performed by physicians and have inherent pre-procedure, intraprocedure, and post-procedure work usually performed each time the procedure is completed. This work should never be reported as a separate E&M code. Other “XXX” procedures are not usually performed by a physician and have no physician work relative value units associated with them. A physician should never report a separate E&M code with these procedures for the supervision of others performing the procedure or for the interpretation of the procedure. With most “XXX” procedures, the physician may, however, perform a significant and separately identifiable E&M service on the same date of service which may be reported by appending modifier 25 to the E&M code. This E&M service may be related to the same diagnosis necessitating performance of the “XXX” procedure but
cannot include any work inherent in the “XXX” procedure, supervision of others performing the “XXX” procedure, or time for interpreting the result of the “XXX” procedure. Appending modifier 25 to a significant, separately identifiable E&M service when performed on the same date of service as an “XXX” procedure is correct coding