Wiki Is this billable?

[coder25]

Good morning!

Not sure if this subsequent hosp visit is billable prior to surgery.

The patient was admitted 3/28 with RUQ pain. U/S did not show any cholelithiasis or cystitis. Docs felt it was not due to her GB. She was seen 3/30, 3/31/ and 4/1. It was on 4/1, that her pain worsened after eating and decision for surgery was made on that day and surgery was performed on 4/1.

No decision for surgery was made on 3/31...notes revealed pt to ambulate and eat a regular diet.

Is the 3/31/10 still considered to be billable or should I just be billing the 4/1 visit when the actual decision for surgery was made???

Thanks in advance for your help!

Peggy

 

[FTessaBartels]

I would bill

I would bill all the subsequent visits, including 4/01 with decision for surgery -57 modifier.

Make sure you have good documentation. You will likely get a denial for one or more of these visits and need to appeal with notes.

Hope that helps.

F Tessa Bartels, CPC, CEMC