Wiki Can we bill E&M with debridement procedure?

[mabaquino_1141@yahoo.com]

Can we bill E&M with debridement procedure? Establish patient came in for debridement for non healing ulcer. Patient last seen 3 month ago. Can we bill for E&M if the doctor did an assessment before he does the debridement for the same wounds. Please let me know where I can find reference for these.

 

[CodingKing]

No, It would be bundled in the debridement if that's the reason the patent is coming in.

 

[mabaquino_1141@yahoo.com]

if it's a new or another wounds, can we bill for E&M? can you please tell me where I can get the guidelines for coding debridement? Thanks....

 

[mhstrauss]

if it's a new or another wounds, can we bill for E&M? can you please tell me where I can get the guidelines for coding debridement? Thanks....

Download the NCCI manual, see chapter 11, then begin reading on XI-36. You'll find the guidelines for when an E/M is considered included in a procedure.

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html

 

[CodingKing]

It follows the normal global surgical package rules.

Example
Medicare Claims Processing Manual Chapter 12 subsection 40.1 C.

?If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure. The decision to perform a minor surgical procedure is included in the payment for the minor surgical procedure and should not be reported separately as an E&M service. However, a significant and separately identifiable E&M service unrelated to the decision to perform the minor surgical procedure is separately reportable with modifier 25.

 

[mabaquino_1141@yahoo.com]

thanks.

 

[wynonna]

Would we bill 11000 or 97597 for debridement?