Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

Coding and Billing for E&M Services and Procedures: A Comprehensive Guide, Lecture notes of Medical Sciences

An in-depth analysis of coding and billing for Evaluation and Management (E&M) services and procedures. It covers various types of visits, when it's appropriate to use E&M and procedure codes together, the use of modifiers, and examples of ICD-10 and HCPCS codes. It is essential for healthcare professionals and coders to understand these guidelines to ensure accurate reimbursement.

What you will learn

  • What is the role of modifiers in E&M and procedure coding?
  • What are some examples of ICD-10 codes for E&M services and procedures?
  • What are some examples of HCPCS codes for E&M services and procedures?
  • What are the different types of visits for E&M services and procedures?
  • When can both E&M and procedure codes be used together?

Typology: Lecture notes

2021/2022

Uploaded on 09/12/2022

christin
christin 🇺🇸

4.6

(18)

264 documents

1 / 27

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
Coding an Evaluation and
Management with a Procedure
David J Freedman, DPM, FASPS, FACFAS, CPC, CPMA
Jeffrey Lehrman, DPM, FASPS, MAPWCA, CPC
1
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b

Partial preview of the text

Download Coding and Billing for E&M Services and Procedures: A Comprehensive Guide and more Lecture notes Medical Sciences in PDF only on Docsity!

Coding an Evaluation and

Management with a Procedure

David J Freedman, DPM, FASPS, FACFAS, CPC, CPMA

Jeffrey Lehrman, DPM, FASPS, MAPWCA, CPC

Procedure

E & M

25 Modifier

  • Significant, separately identifiable E&M at same

encounter as a procedure

  • Goes on the E&M code
  • 25 Modifier never goes on procedure code

One Problem gets E&M and Another

Problem gets Procedure

  • “Medicare” Patient scheduled for at-risk foot care who is

found to have tinea pedis

  • Procedure to trim dystrophic toenails
  • E&M - Tinea Pedis

One Problem Gets E&M and Another

Problem Gets Procedure

  • Patient scheduled for biopsy and they say heel has been hurting.
  • Procedure for punch biopsy
  • E&M Plus X-ray-plantar fasciitis with stretching, ice, and dispense insert

One Problem Gets E&M and Another

Problem Gets Procedure

  • Patient scheduled for biopsy and they say heel has been hurting.
  • Procedure for punch biopsy
  • E&M Plus X-ray-plantar fasciitis with stretching, ice, and dispense insert ICD-10 Codes:
  • 1 – D49. 2 Neoplasm of unspecified behavior of skin
  • 2- M79.671 Pain right foot
  • 3 – M72.2 Plantar fasciitis

CPT Codes:

• 1 ,2– CPT 11104 – RT

  • 3,2 – CPT 99213 - 25 modifier
  • 3 – CPT 73630-RT

New Patient

  • Ingrown toenail requires a procedure-removal

E&M working up the patient for this initial

encounter for a new problem requiring a

procedure.

ICD-10 Codes:

  • 1 – M79.675 Pain in left toe
  • 2 – L60.0 Ingrowing nail

CPT Codes:

• 2,1– CPT 99202

• 2 – CPT 11730 - TA

Initial Encounter-New patient

  • Neuroma with x-ray and injection

Established Patient with a “New”

Problem

  • Someone treated for plantar fasciitis 8 months ago

comes in with an ingrown left hallux nail

Established Patient with a “New”

Problem

  • Someone treated for plantar fasciitis 8 months ago comes in with an ingrown left hallux nail

ICD-10 Diagnosis Codes:

  • 1 – M79.675 Pain in left toe
  • 2 – L60.0 Ingrowing nail

CPT Codes:

  • 2,1– CPT 99213 – 25 mod
  • 2 – CPT 11730 – TA