Wiki Er visit followed by surgery 2 days later

[SienTC1720]

I'm wondering how you would bill, if at all, the ER visit done 2 days before the lap cholecystectomy. I don't think that would fall under the surgical package, but the whole ER part is what really confuses me. Anyone have any ideas?

 

[aclements]

I need a little more information before I can guide you. Is it safe to assume the physician performing the surgery is the same physician who saw the patient in the ER? If so, the surgeon can bill for the ER visit. You will use the POS 23 for ER and the appropriate E/M code. One option is an outpatient consult code (if he/she was consulted and if the insurance accepts consults) etc. Modifier 57 is not needed. It is only used when the decision for surgery was made on the day before or the day of surgery.

 

[SienTC1720]

I am billing for the surgeon, and now that I reviewed more, I see that the patient came in for an office visit, not ER, she had just been to the ER previously. He saw her 6/16, performed surgery 6/18.