Billing, CMS, Coding, Evaluation and Management, Modifiers, Procedure



  1. McNicholas, Faith C. M.


ABSTRACT: The Centers for Medicare and Medicaid Services added enhanced narrative under the Integumentary section of the National Correct Coding Initiative code edits that affect the reporting of an evaluation and management (E/M) service on the date of service (DOS) as a procedure.


Although the enhanced narrative indicates that an E/M service is included in the minor procedure when reported on the same DOS, it does not preclude providers from reporting a separate E/M service-when performed and accurately documented.


For successful, stress-free reporting of E/M services and procedures on the same DOS, providers must remember that the safest, practical policy is to ensure that the E/M documentation indicates that the service was above and beyond that which is included in the procedure and, upon review, must stand on its own merit to support the level of service reported.