Ob-Gyn Coding Alert

Question: Can a physician report a dual-energy x-ray absorptiometry (DEXA) scan and a consultation performed on the same day?

Ohio Subscriber

Answer: If another physician asked the ob-gyn for the consultation (99241-99245 for outpatients and 99251-99255 for inpatients), he provided his opinion and reported it back to the requesting physician, you can bill the consult and DEXA scan (76075, Dual-energy x-ray absorptiometry [DEXA], bone density study, one or more sites; axial skeleton [e.g., hips, pelvis, spine]) performed on the same day. A consult, however, also requires that the person who is billing has seen the patient for that consultation. The consulting physician would then order the DEXA scan and secondarily bill for interpreting it. You should append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the consult code.

If the requesting physician only asked the ob-gyn to perform the DEXA scan and provide an interpretation, this would not be a consultation, and you should report only 76075.

The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC, MA, an ob-gyn coding expert based in Fredericksburg, Va.