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TRICARE Policy Manual 6010.60-M, April 1, 2015
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.
99201 - 99215
When surgery is performed at the time of the office visit.
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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