# Consult billing on same day as Moh's Surgery?



## Jen Verlinda (Jun 3, 2009)

Hi Everyone, 

I was wondering if it was proper to bill a consult visit on the same day as the surgery.  The codes I am billing are:

99243-25
17311
17312 x 2

Thanks!


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## FTessaBartels (Jun 3, 2009)

*What is reason for the visit?*

If the patient is being sent to you FOR the procedure, then it's not a consult, it's a transfer of care. 

F Tessa Bartels, CPC, CEMC


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## mitchellde (Jun 3, 2009)

I agree with Tessa, this really looks like just procedure codes are all that is needed, I worked a long time in the Cancer center and never did a patient come in for a consultation and leave with bandages post Mohs.  Not even a regular office visit.  This is something that is well planned in advance and set up so there should be no visit level of any variety.  FYI ... IF on the outside chance that you did have this scenario then you would use a 57 modifier not the 25.


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## Karolina (Jun 4, 2009)

I also find it peculiar that the patient comes for a consult and has the procedure on the same day. Did another provider send the patient for an opinion and recommendations? Was the decision to perform the procedure made during this visit? If so, it is a highly unusual setting and will likely promt a review, so if this is all true then make sure your provider documents it appropriately. I have seen the scenario where a patient was sent for a consult to the MOHS specialist and when this specialist decided to go forward with the procedure it was scheduled on a different day.


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## Jen Verlinda (Jun 5, 2009)

*Moh's and consult same day*

Thanks for the responses everyone.  I did forget to mention that my provider does perform consults on the same day as surgery because we are also a freestanding ASC.  The referral is sent from another physician and the case is reviewed by my physician prior to the visit.  Then the full consult is done same day as surgery because of the combined office/ASC setting.  This practice is relatively new, so I was hoping there were other people out there with this same scenario.  Thanks alot. 

Jen


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## FTessaBartels (Jun 9, 2009)

*Referral*

Jen, you write: The *referral* is sent from another physician and the case is reviewed by my physician prior to the visit. Then the full consult is done same day as surgery because of the combined office/ASC setting.

This is not a request for an opinion. This is a transfer of care. 

It's not a decision for surgery, either ... the surgery was already scheduled (i.e. decided on earlier).  

I say no E/M at all. 

F Tessa Bartels, CPC, CEMC


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## mitchellde (Jun 9, 2009)

Tessa took the words right off my keyboard!  So I agree no visit at all.


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