Any advice on billing the following scenarios:
A patient comes in for a well visit and also a sore knee (stated as the reason for visit). We are getting reimbursed for the well but not the e/m involved in the knee (just an example). We've been using well e/m plus a sick e/m plus the modifier 25. No reimbursement for sick e/m.
A patient comes in for a well visit (as stated as the reason for the visit). During the exam, a suspicious lump is found (now we have a sick visit, right?) Again, we've been using a well e/m plus a sick e/m with modifier 25. No reimbursement for sick e/m.
Would using modifier 33 for preventative (well) help us to get reimbursed for dr's extra exam and medical decision making?