In response to this and your question about E/M and cryotherapy, the simplest thing to do, and this is what I tell doctors/coders:
Audit the treatment note and remove everything relating to the procedure, since an E/M component is already factored into the RVU's for the procedure. Whatever you have left over will determine if you have the elements necessary to bill an E/M. This applies to new and established patients both. If you do have the elements, then determine your level of E/M accordingly, and bill it with a 25 modifier. If you don't have the elements needed, then just bill the procedure performed. As with everything, there are rare exceptions to this...such as if you can use time as an element with the appropriate documentation of time spent face to face with patient and nature of the counseling/coordination of care. Generally though, if the only thing addressed at the time of service is related to the procedure, you will not have a separate, significantly identifiable E/M.