How to charge for E&M services, procedure on same date
Written by Mark Painter and Ray Painter, M.D.
Our office has adopted a policy that does not allow coding for an evaluation/management visit on the same date as a previously scheduled cystoscopy. At your course, you said that if an E&M service is separate and identifiable, you can charge for the E&M with modifier –25. If I talk to a patient and/or treat BPH and ED on the same date as a scheduled surveillance cystoscopy, can I charge an E&M with a modifier –25?
E&M services reported on the same date as a procedure with a global require that the E&M service is separate, significant, and identifiable. There is nothing in the requirement for there to be a new problem, nor is there a rule that states you cannot charge an E&M code on the same date as a previously scheduled service. A cystoscopy has a 0 day global, which includes the related preoperative care, the procedure itself, and the postoperative care, including telling the patient the findings of the services. The postoperative care does not include discussing or treating the disease process related to the procedure or any other disease process. All services regardless of whether they are new or established that are addressed on the same date can be charged if the E&M service is not a part of the procedure(s) provided and it is documented appropriately and accompanied by the –25 modifier.