Lori Posted Wed 13th of June, 2012 13:02:24 PM
I had a question re: the bladder cath CPT code
51701 and if it could be billed along with a Level 3
99213 office visit code? If so, could the same diagnosis code be used and would it require modifiers on both codes?
Thanks for your input..
SuperCoder Answered Wed 13th of June, 2012 16:45:41 PM
Modifier -25, Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service:
This modifier must be appended with an E/M service. This is the modifier you will need to use with the evaluation and management service done on the same day with other procedure done by the same physician. It has to be above and beyond the usual preoperative and postoperative encounter with the procedure. In fact, by using this modifier, it doesn't have to have a different diagnosis reported. The most important thing is that, the E/M level should meet its key components or if it is selected based on time spent with the patient (counseling and coordination of care). You have to be careful in using this modifier. It must meet medical necessity. As you know, there are procedures that already includes all other coordination of care and management.