Wiki Follow up

[KoBee]

If a provider sees the patient for a procedure that was prescheduled and is trying to also bill a separately E/M with just " for further follow up " on same day , my understanding that if patient is scheduled for a prescheduled procedure, then the provider cannot bill a separate E/M especially if there is no complaints or concerns from the patient.


Please advice

 

[Lyta2000]

Correct. The procedure payment includes a certain amount of “pre-procedure” work. Like vitals, review of systems, maybe even a re-examination. To be paid for a separate EM the doctor needs to have done something beyond that work. It must be clear in the documentation.