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WEEKEND MAINTENANCE: The maintenance outage is scheduled for June 22nd at 6:00am EST ending NLT Sunday, June 23rd at 11:59pm Eastern EST. The TRICARE Manuals web site may be available intermittently during this period but it's usage is not recommended.

TRICARE Policy Manual 6010.63-M, April 2021
Administration
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 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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