99024 and unrelated office visits

[Lunap99]

Our patient comes in for a follow up after sx. The provider codes 99024. The patient also has an unrelated complaint. The provider bills a 99213-24. The question is, can we bill both 99024 and 99213-24, or should we only use the 99213-24?

 

[twizzle]

Yes, you can bill both. Billing 99024 is appropriate to act as a 'paper trail' for the post-op visits and the office visit then stands alone as separately billable with mod 24 and a new diagnosis.

 

[csperoni]

I have only billed the 99213-24. I suppose if I was in a state where submitting the 99024 postop for specific procedures is required (I'm not), then I would bill both. I would also consider coding both if the provider created 2 separate notes. I have never had a provider create 2 separate notes for that situation, although it would make denial disputes easier.

 

[amyjph]

Agree with both responses. I don't think it's a question of actually "billing" (to the payer) unless you live in state requiring reporting of the 99024 as stated above. Some practices want to track all 99024 so while 99024 would be entered into the practice management system, it wouldn't actually be released on a claim. I have seen some practices require entry of all procedures & services for tracking while others don't want them entered at all. It's the same idea as surgical billing and bundling. In some cases you would enter everything performed even if it bundled or was not billable so the provider gets "internal" credit but you would not release it on the claim.

Of course you would have to make sure the documentation supported coding a separate E/M if you remove all of the documentation related to the post op. Two separate notes would make things a lot easier but I have never seen a provider make two separate notes either.