Wiki Office Visit & SX

[Hopp]

Please help me coding following: New pt presents to office
with infected cyst back. Doc schedules him same day for
sx @ hospital. ? being. - Can I code both the OV and Sx?
If so do I just append ov with 57 modifier or do I use both
57 and 25 TIA for any advice
Deb, CPC

 

[jdibble]

Hi!

If the decision to do the surgery was made during the E/M (which is what this sounds like) then you would bill the E/M and the surgery. You would use only the -25 or the -57, not both and the choice would depend on the procedure the doctor is performing and the global period. If the procedure has a global period of 0-15 days, then you would use -25. If the global period is 90 days, then use -57.

Hope this helps!

Jodi Dibble, CPC