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Urology Coding Alert

Reader Question:

52000 + E/M Depends on Planning

Published on Wed Oct 19, 2011

Question: If my urologist has a patient return to the clinic for an annual cystoscopic examination in follow up for a bladder tumor resected two years ago, and he performs an examination and reviews the history during the visit, can I bill an E/M code with the cysto if he didn't have a separate diagnosis?Oregon SubscriberAnswer: Whether or not you can separately report the E/M service using a subsequent office visit code such as 99212-99215 (... established patient, subsequent office visit) depends on some details about the patient's visit.Option 1: If the cystoscopy was a scheduled procedure, scheduled at the time of a recent encounter with the patient, then you should not separately bill for an E/M service just  to repeat the findings and history previously obtained at that first visit.Option 2: If the urologist examines a patient he is following for a bladder tumor removed in the past, and [...]
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