Neurosurgery Coding Alert

READER QUESTIONS:

Choose Best E/M for Ventric Follow-Up

Question: Our neurosurgeon clipped an intracranial aneurysm and created a separate ventriculostomy incision. He followed up with the patient a few days later to check the ventriculostomy for hydrocephalus. He says a seminar leader recently taught that you can bill for the ventriculostomy follow-up visit even though the original procedure happened on the same day as a surgery with a 90-day global period. Is this true? Missouri Subscriber Answer: Your physician could be correct, depending on the circumstances. If he sees the patient for something unrelated to the aneurysm clipping, you could possibly bill the appropriate E/M code for an established patient visit. Choose from 99231-99233 (Subsequent hospital care, per day, for the evaluation and management of a patient ...), assuming your physician saw the patient in the hospital. Modify it: Check whether the payer requires you to append modifier 24 (Unrelated evaluation and management service by the same physician [...]
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