# Needle breast biopsy with post op office visit



## debarr (Jul 14, 2009)

A doctor did a needle breast biopsy on a patient which has a 10 day global.  They are brought back to the office to discuss results.  If nothing is found from the biopsy-there will be no charge.  They want to charge an office visit if it is cancer because they are spending up to an hour discussing options and treatment plans with the patient.  Is that billable with a counseling code?  I need opinions.


----------



## mitchellde (Jul 14, 2009)

no it is global you may not bill.


----------



## debarr (Jul 15, 2009)

We have a person that states you can bill based on time (E&M) visit with a modifer 58 (staged or related procedure or SERVICE)-service they are saying.  I didnt think you could use 58 modifer on and E&M visit. Any opinions?


----------



## mitchellde (Jul 15, 2009)

You are correct, you may not use the 58 for an E&M code, E&M codes may use only E&M modifiers.


----------



## JSYLVAIN (Aug 6, 2009)

Needle biopsy codes 19100, 19102 & 19103 do not have global days. We do a follow up visit when needed, billable, but do not take copay for that visit as standard office policy.


----------



## mitchellde (Aug 6, 2009)

good point, what code was being used for the needle bx?


----------



## Monika Liddle (Aug 8, 2009)

The office copay is an agreement between the insurance company and the patient. I believe you should be collecting the copay if you bill the insurance company.


----------



## Zina (Aug 13, 2009)

You can bill the visit with most insurances, just use the breast cancer dx, and add modifer -24 if needed. You should be careful about the copay issue, some insurance companies view that as a violation of your contract with them.


----------



## denise.zalusky@providence (Dec 21, 2020)

Since this is a "new diagnosis" a visit can be billed with the new diagnosis and a 24 modifier on the visit. This is not related to the post op care of the procedure/biopsy. And...agree if there was not a finding on the biopsy the visit would be related to post op care and not billable.


----------

