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Reader Question: Demonstrate Distinct Multiple Procedures to Unbundle CCI Edits

Posted on 25. Feb, 2015 by in Coding Challenge

Question: Our podiatrist visited an established patient at a nursing home but noted an infection and tinea pedis not previously seen. His notes describe an I&D on the left hallux, and he also wrote orders for the tinea pedis. Additionally, he performed nail care 11721 with Q8. How should I code this encounter? Please share some info on the I&D procedure.

Missouri Subscriber

Answer: As the visit was a subsequent visitation to a nursing home for an established patient, you should report the visit with code 99307 (Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components …) attached with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service). This is based on the assumption that your physician...

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