Wiki Wart removal + office visit

[Brenda88]

Hi!
I recently told a provider that she cannot charge an office visit with wart removal with both having the same dx for warts, that the office visit would have to be for something else. She asked what if she treated ONE wart with liquid nitrogen/removal, and then she prescribed a cream for the other 3. So they are for different warts. I'm not 100% sure...?

 

[podcoder70]

There are a number of reasons that an E/M can be coded with the same diagnosis as the procedure...ALL of them are dependent on documentation...
New patient
Established patient with new problem
and the scenario you gave...although, I would not recommend making that a habit, and the documentation needs to be very clear that 2 different warts were treated and WHY they were treated differently...otherwise it just looks like you are doing it to get the E/M.

 

[TatyanaNegovan]

It is acceptable to bill procedure with office low LOS 99212-25. The common practice via EPIC is to bill procedure with 99999 - phantom code to make the system process, but providers feel more comfortable with EM code.