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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