Evaluation And Management
Chapter 2
Section 1.2
Office Visits With Surgery
Issue Date: March 1, 1996
Copyright: CPT
only © 2006 American Medical Association (or such other date of
publication of CPT).
All Rights Reserved.
Revision:
1.0 CPT
PROCEDURE CODE RANGE
99201 - 99215
2.0 DESCRIPTION
When surgery is performed at the time of the
office visit.
3.0 POLICY
When a surgical procedure is performed at the
time of an office visit, both the office visit and the surgical
procedure are covered when modifier 25 is used as the basis for
this situation (indicates that the patient’s condition required
a significant, separately identifiable Evaluation and Management (E/M)
service above and beyond the usual preoperative and postoperative
care associated with the procedure that was performed). If the modifier
is not used, the charge for the office visit is to be denied.
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