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Office Visits with Minor Procedures – Suzanne Corcoran, COE

When you perform minor surgical procedures in the office, the exam performed that same day is usually considered incidental and not paid separately. However, there are exceptions, i.e. when the patient’s condition requires an additional service beyond the usual care provided as part of a procedure. When a separately identifiable service has been performed on the same day as a minor procedure, use modifier -25 with the exam (992xx or 920xx) or consultation code (9924x). CPT defines modifier -25 as referring to a “significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service.” Note: If the only purpose of an exam is preoperative care, a claim for an office visit with modifier -25 would not be appropriate.

To view the entire article in Ophthalmology Management click on the link below:

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