# scopes w/ new pt visit



## sundaey (Mar 24, 2008)

We have an ENT doc that scopes every new pt that walks in the door. Can you bill for both the scope and the new pt visit with a -25?
I dont think that he should get both b/c it's not significant or separately identifiable/nor is it above and beyond the normal scope for him, however, my boss doesn't agree.

I would appreciate any feedback.


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## efrohna (Mar 25, 2008)

If your ENT provider is *only* documenting the scope procedure, then you are correct no New Patient Visit should be billed in addition to.  

However, if the ENT provider is documenting ALL 3 components of a New Patient Visit:  History, Exam & Medical Decision Making, AND the scope procedure, you may bill for both.  Don't forget the 25 modifier on the E/M.

Documentation is key, especially the medical decision making!
E. Frohna


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## Candice_Fenildo (Mar 27, 2008)

Evangalina is correct, if an E/M eval is being performed with all the bullets documented and a scope is performed 992xx -25 and the scope.


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