Oncology & Hematology Coding Alert

Question: In a patient planned for a biopsy, our physician did an evaluation for about 20 minutes to determine fitness for the procedure. During the preparations for biopsy, the patient had questions for which he received counseling from the nurse practitioner. The nurse spent about 15 minutes in this discussion. Following this, the patient consented to and underwent the biopsy procedure. How can we report the evaluation services of the physician and the counseling provided by the nurse?

Kansas Subscriber

Answer: For every procedure performed, it is expected the provider would evaluate the patient to determine the patient’s fitness for the procedure as part of the pre-procedural work up. The description of the nursing time also is part of the procedural service as well as obtaining consent. Additionally, this was stated to be a planned procedure, therefore you would only bill for the procedure performed.