Gastroenterology Coding Alert

Reader Question:

Don't Waste Time Billing $0 Charges

Question: I bill post-op visits with 99024 and charge $0. Sometimes it goes through, but today I had a status message that BCBS rejected my claim with three services of post-op visits stating: "at least one line item charge amount must be > than zero." What do I do?

Washington Subscriber

Answer: Don't bother billing out the zero-dollar post-op services with 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure). You should delete the claims and disregard the rejected claims.

Blue Cross Blue Shield (BCBS) does not want to track non-charges. In fact, most payers only want follow-up or post-op care submissions that contain fees.

Suggestion: The patient's medical record should contain documentation of any post-op visit. You may also want to post the charge to your system for internal audit and tracking purposes.

Your software should then allow you the option of not sending the claim for zero-charge services. This would work the same as services entered as "N/C." You may need to consult your software vendor for assistance on entering "zero" charges without a claim being generated.

-- Clinical and coding expertise for this issue provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA's CPT Advisory Panel; and Linda Parks, MA, CPC, CMC, CMSCS, an independent coding consultant in Atlanta.

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