Urology Coding Alert

Question: If a cystoscopy and an emergency consult must be performed on the same day, how should we code to obtain reimbursement of both?

Paul Polishuk, MD, CA

Answer: Use the appropriate level consultation codes (99241-99245, 99251-99255). Any time there is a significant, separately identifiable evaluation and management (E/M) service at the same time or on the same day as a procedure, it also may be billed with a -25 modifier appended to the E/M service. Many insurance carriers will ask for documentation before paying for this service. Medicare has recently clarified the use of consultation codes and has confirmed that providing a consultative service and performing a procedure on the same day is acceptable.