Wiki Endovenous LaserAblation

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Bremen, AL
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I'm new to the world of veins and have a few concerns about the current billing process for ablations and phlebectomy. The current CPT's being used is 36478, 37765 and 93040.
For the primary encounter they are billing :
36478 (R,L)
37765 (R,L) 58, 51 59
93040 59
CPT 37765...I'm not sure that the 58 should be filed since this is the primary encounter or Modifier 59 since these two procedures are typically done at the same time.
CPT 93040... does it need a 59?

When the patient returns for the second encounter on a different leg would it be appropriate to use MOD 58 on 36478 and 37765?

I also am curious if I can bill 37765 and 93040 under the physician and 37765 under the PA since the PA does the phlebectomy after the physician has left the room.
 
EVLT/Stabs

I don't use a modifier at all when I bill 36478 and 37765 together...there aren't any CCI edits saying you need to. I wouldn't use a 58 on the 2nd encounter when it's on a different leg. Also where are you getting the 93040 from? I don't see any mention of an EEG.
 
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