kpeters88
Contributor
understand that a provider should not bill a separate E&M code unless the E&M is unrelated. I am also aware that procedures that were planned in a previous visit during which the patient had an initial work up for the decision to plan the procedure qualify as the E&M workup and the E&M is not to be charged again on the day of the procedure.
My physician is convinced that we can charge for an E&M in two cases where the coders have disagreed:
CASE 1: First visit, initial consult - dx - urgency of urination, incontinence, hematuria, abdominal pain. PX - E&M, cath, UA. Plan - schedule cysto in 2 to 3 weeks, no meds want to try bladder retraining first, bladder retraining.
2 to 3 weeks later patient comes in for cysto - dx still hematuria, abdominal pain, incontinence, and urgency of urination. Px - cysto and E&M. Plan bladder retraining continue, prescribe meds, follow up in 1 month.
Can the cysto and E&M be charged together for the follow up even though the cysto was planned because the physician changed the plan by adding medications?
My physician is convinced that we can charge for an E&M in two cases where the coders have disagreed:
CASE 1: First visit, initial consult - dx - urgency of urination, incontinence, hematuria, abdominal pain. PX - E&M, cath, UA. Plan - schedule cysto in 2 to 3 weeks, no meds want to try bladder retraining first, bladder retraining.
2 to 3 weeks later patient comes in for cysto - dx still hematuria, abdominal pain, incontinence, and urgency of urination. Px - cysto and E&M. Plan bladder retraining continue, prescribe meds, follow up in 1 month.
Can the cysto and E&M be charged together for the follow up even though the cysto was planned because the physician changed the plan by adding medications?