Ob-Gyn Coding Alert

Question: What is the best diagnosis code to use when the gyn-oncologist sees a patient during the post-op period but discusses the prognosis of the disease and the treatment options available such as radiation versus chemo or a combination of both? Our physicians sometimes spend two to three hours with a patient going over treatment options. If we use only the cancer diagnosis code, the charge is rejected even with modifier -24.

New York Subscriber 
 
Answer: Modifier -24 (unrelated evaluation and management service by the same physician during a postoperative period) is the only correct modifier for this service. Your physician should contact the medical director of the plans that reject the service to find out why this is happening.
 
The postoperative period following surgery is only for those services that are routinely needed for the recovery from surgery, not additional treatment options. As to the diagnosis, the patient who has just had surgery will still require the cancer diagnosis, and no other V codes apply in this case. You may have to send documentation with each encounter you are billing to stop the initial rejection.