We had a Conversation going on in our office regarding usage of 25 modifier along with E&M 99213 (Outpatient visit) Were patient came with the complaint of Painless bleeding during bowel movements after examining the patient physician found that patient is having Bleeding internal hemorrhoid were he decides to do a Hemorrhoidectomy by rubber band ligation(s) on the same office visit and performed the procedure

Dx codes: K64.8

99213-25 ? -K64.8
46221-K64.8

We are being advised that we cannot use 25 modifier for the above scenario

Anyone with feedback on this would be greatly appreciated..