Wiki In office surgery code for the office visit

[mrumbo]

My office preforms in office out pt surgery procedures done under anesthesia. What is the code that we would use to bill for the place of service. The billing person used 99215 and the insurance denied it. I'm new to this practice and currently taking the coding class and the girl doing the billing is clueless.

Thanks
Michell

 

[mitchellde]

The code for place of service is not 99215 . That is an E&M visit level. You need the CPT code for the surgery that was performed. If this is performed in an office setting not part of a hospital outpatient department the POS is an 11. If this procedure is not approved for physician office then you will need to write it off. You cannot bill a different code than the one that represents what was done.

 

[AnnaE]

99215 is an office visit cpt code. The place of service for an office visit is 11. What was the surgery performed?

 

[OCD_coder]

It would be helpful if we all knew what kind of anesthesia was given to the patient at the time of the procedure. It is a rarity to have general anesthesia given in an office setting, most physicians are not comfortable with something more than moderate conscious sedation within an office setting.

I am not saying it can never be done.