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Preventive + Problem-Oriented E/M on the Same Day (Modifier 25) The second perennial confusion: the patient comes in for their preventive visit and says, while Im here, my anxiety has been much worse. When a significant, separately identifiable problem is evaluated and managed during a preventive encounter, CPT permits reporting both the preventive code (99396) and a problem-oriented E/M (99213 or 99214, as supported) with modifier 25 appended to the problem-oriented code

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