Wiki Suture Removal with E/M Visit

Create Wiki
B

bar2ty@yahoo.com

Networker
Messages
27
Location
Fuquay Varina, North Carolina
Best answers
0
Pt comes in for reexam. Decide to have lesion removed right then. Is -57 attached to E/M code or just bill for surgical procedure with E/M being included in the surgical package (pre-op)?
Also,
Pt returns to have suture removed, I know that I do not bill for that, because it is included in the surgical packg, but there is an OV (PF), do I bill for the office visit-this is not the post-op visit?
Also,
Pt returns again for post-op visit which I know I do not bill for.

Any HELP is appreciated.:confused::confused:
 
#1 as far as whether to bill the E&M and the procedure depends on the note and the reason for the encounter. If the patient were scheduled ahead of time for the procedure then you would bill the procedure only. If this was not prior scheduled and he provider note contains relevant documentation that exceeds what is part of the procedure then you may bill the E&M and the procedure but the modifier is a 25.
#2 if this is to remove sutures from anything but a lac repair then it is global, the ov is also global,unless documentation and diagnosis can support an entirely different reason for the encounter then you need a 24 modifier
#3 lac repairs for most payers have 0 global so post repair visits can be billed.
 
Thanks Debra,
I researched and realize that -25 is needed for the procedure.

Does minor in office procedure (removal of benign lesion) fall under surgical package? if not, then do I have to bill for all of the subsequent office visits?
 
You must log in or register to reply here.
Top