Wiki inpatient visit and procedure on same day

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sjobe

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My doctor was called to see a young man with commercial insurance for a spinal headache. My doctor did a full consult and reviewig the dictation it was a 99221 level. And in the dictation my doctor decides to do an epidural blood patch. i think it should all be billed as the following:
99221-25 with diagnosis of 784.0
62273 and 349.0
please help as am beginning to see this alot. my docs called to consult on a patient then do some sort of pain management procedure.

Thanks
in dallas
 
I haven't read the procedure note, but it is my understanding that you will not be able to bill for the consult, as it is the same day as a minor procedure. You can only bill for the procedure. A -25 mod (significant, seperately identifiable E/M) attached to the consult will not work, because the consult and the procedure are related. We run into this often in our practice, and we are only able to code EITHER the E/M OR the procedure. We only code both if the E/M is for a completely different reason than the procedure.

Hope this makes sense!
 
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