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Click here for more sample CPC practice exam questions and answers with full rationale

Over Coding Issue

Hi Everyone,

I’ve recently started a new position with a family planning clinic and I’m the first coder they’ve ever had. The previous billing supervisor, who is no longer with the company, put a rule in place that all procedures should be billed with an E/M code & modifier 25. As we all know E/Ms shouldn’t be billed with surgical services unless there is a separately identifiable reason. This rule has been in place for approximately 2 years and our predicament is what to do about the over-payment from the insurance companies. Has anyone run into this in the past? How did your organization handle it? Thank you for any input!

Medical Billing and Coding Forum