Anoscopy(flexible fiberoptic) during evaluation and management?

Abbi Schoenhofer

Contributor
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Okay... I'm beating my head against the wall here. Hoping anyone out there can help! I am getting two completely different views on this subject everywhere I turn. Here is the scenario:

Patient presents for a consultation with surgical specialist for Hemorrhoids and Rectal Fistula. The dictation is a FULL evaluation and management visit, and during the exam, "Fiberoptic anoscopy was performed, scar tissue and hypertrophy papilla were seen."

To bill separate procedure or not? Here is the question: Do you bill a New patient visit(or consult if non medicare) with a modifier -25, and bill the 46600 for the anoscope procedure, OR is this procedure content to the E/M?

I've had several say it's content to the E/M, and other say no... it's separately identifiable. Any help would be so appreciated!:confused:
 

jemimah crescentia

Networker
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As per my opinion Anoscopy procedure could be coded separately along with the consult or new patient visit for the above scenario.

Jemimah Crescentia,CPC
 

ajs

True Blue
Local Chapter Officer
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I agree...new patient, procedure not previously planned, code the New pt E/M with 25 modifier and then the procedure code.
 
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