Billing the G0101 code for pelvic and clinical breast exams on the same day as a CPT preventive visit is considered double billing for that portion of the examination, as CPT codes 99381—99397 already include an age and gender-appropriate history and physical exam. Commercial Payers: Many comm...
these systems are recognized as Constitutional (i.e., fever, weight loss); Eyes; Ears, Nose, Mouth Throat; Cardiovascular; Respiratory; Gastrointestinal; Genitourinary; Musculoskeletal; Integumentary (skin and/or breast); Neurologic; Psychiatric; Endocrine; Hematologic/Lymphatic; and Allergic/Immunologic...
• When using 25 on an E/M service on the same day as a procedure, the E/M service must have the key elements (history, examination, and medical decision making) welldocumented. NOTE: However, although CPT does not limit this modifier to use only with a specific type of procedure or...