Wiki billing E/M level instead of injection

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Ryannam

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I have a Dr. who has a question about billing just for his E/M level vist and not for the injection that he gave the patient due to it probabaly being denied. Is this kosher. I am under the impression that you cannot just do this? Any feed back would be appreciated.
 
If the patient is only there for the injection its medically unnecessary to perform an E&M so you cannot bill and E&M in place of the injection as that is not the procedure performed. I'd consider that upcoding if it increases reimbursement (eg 99213 pays more than trigger point injection) or downcoding if it results in underpayment (eg 99212 pays less than a trigger point injection)
 
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If your provider (or other staff, including yourself) think a procedure may not be covered, then ask the patient to sign an ABN.
 
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