Wiki 99214 and 57160

[Ocean1529]

I am looking for help as I am new to coding. A provider saw a patient in the office with prolapse and they spent a significant amount of time discussing treatment and in the end they decided to go with a pessary. The provide is asking me to bill a 99214 and a 57160. Can I bill for both or is the H/P and ROS included in the 57160?
Any help would be appreciated....
Thank you.
Tracey D.

 

[mitchellde]

you will need to append a 57 modifier to the 99214. As far as can you bill that way for this encounter, that answer depends on the documentation for this encounter. The assessment of the patient must be over above and beyond what is necessary to perform the procedure.

 

[Ocean1529]

Thank you Debra. I do not believe there is enough to be above and beyond so I will not use both.
Great info...thanks again