Wiki Can an E&M be billed in place of a sphenocath?

[lanquockieu]

Hi all,

For certain minor procedure, if the provider clearly documented time spent, can she bill an E&M instead of the procedure? Our doctor wants to know if she can bill for Sphenocath using an E&M based on time spent since there is no specific CPT code for it. CMS wants an unlisted CPT 64999 with the description for the device used.

Thank you in advance!

 

[Pam Warren]

Absolutely not.

First page, first paragraph of CPT instructs you to report the service that most accurately describes what is being performed. If there is no specific surgical/procedural code you'd report an unlisted code, but never an E&M in place of a procedure.