Wiki Help on charges

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asasands

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Nobody has responded on the E&M boards so hoping somebody could help me here.

A person had surgery and came back for his post-operative appointment within the global period. He was complaining of diarrhea so our surgeon did a direct admit into the hospital. Can we charge for this visit with an E&M charge even though it is within the post-op period?

Thanks for any help

Stacey
 
Well, with what you have said, you cannot charge for an E&M. Making an assumption as whether or not the diarrhea is a post-op complication, you can not charge for the E&M because the patient was admitted to the hospital. All of the work that is involved, including the office visit, will be reflected in the addmission. I am not aware of any ins. companies that will pay for an E&M and initial hosp. visit on the same day. So if you doc did all the work, you will only bill the admission. Hope this helps.

Tina
 
What was surgery for?

If the surgery was bowel related, this is probably not going to be considered "unrelated."

If, on the other hand, the patient had an ORIF for a fractured tibia, this might be completely unrelated to the surgical procedure.

You will need the appropriate modifier if this was unrelated to the surgery.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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