GYN question. Is second visit part of global?
5/18 Pt was seen by MD with vaginal bleeding. MD makes decision to do surgery & performs Pelviscopy with lysis of adhesions &/or excision fulguration of endometriosis. E&M visit billed (99245)
5/20 Pt had video pelviscopy, lysis of adhesions, aspiration of the cul-de-sac, D&C & hysteroscopy. Documents in OR note: Outlook for future: Hysterectomy. Will discuss with pt whether to keep or remove ovaries.
6/8 HPI states: "Pt here today for pre-op eval for hysterectomy & has nothing to do with her postop pelviscopy eval. Repeats full ROS & comprehensive exam & counsels pt on upcoming surgery.
Is this visit billable? Or is it the decision for another surgery?
Thanks!
5/20 Pt had video pelviscopy, lysis of adhesions, aspiration of the cul-de-sac, D&C & hysteroscopy. Documents in OR note: Outlook for future: Hysterectomy. Will discuss with pt whether to keep or remove ovaries.
6/8 HPI states: "Pt here today for pre-op eval for hysterectomy & has nothing to do with her postop pelviscopy eval. Repeats full ROS & comprehensive exam & counsels pt on upcoming surgery.
Is this visit billable? Or is it the decision for another surgery?
Thanks!
Comments
This depends on the global days assigned by the plan for the pelviscopy / fulguration procedure.
The physician has the right to re-evaluate a patient after a procedure and create a treatment plan.
Review the CPT that was used to bill the procedure. If it has a 10 day global, then yes the 6/08 DOS can be billed without a modifier. If the procedure has a 90 day global, then modifier -79 could be appended to the E/M service, but be certain the revised diagnosis is used when submitting the claim - as this distinguishes it as an updated reason for seeing the patient.
Karen A. Hurley, BS, CMM, CPC, CNA
President, HPMSI
PO Box 409
Parrish, FL 34219
Tel: (941) 776-4822
Fax: (240) 368-0059
Web: www.hpmsi.com
Since 1996, Celebrating 20 years of Service to Physicians
Karen A. Hurley, BS, CMM, CPC, CNA
President, HPMSI
PO Box 409
Parrish, FL 34219
Tel: (941) 776-4822
Fax: (240) 368-0059
Web: www.hpmsi.com
Since 1996, Celebrating 20 years of Service to Physicians