Bartholin's cyst

YBYERS

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Hi all,
Pt was seen in the ER and my doc was called in to do a procedure (don't know yet if it was excision of Bartholin's cyst or marsupialization of Bartholin's cyst). Do I bill only for the procedure or can I also bill for a consult or transfer of care visit? Patient was not admitted as inpatient.
Thanks in advance for your help..
 

Bready

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With either I&D or marsupialization of the Bartolin's gland cyst, E&M is included in the procedure per Medicare guidelines. You could try with a consult code and modifier 57 (along with the procedure code), but most carriers are going to go by the Medicare guidelines and reject the E&M or consult code as included in the procedure. You might also need a separate documentation for the consult.

I would bill only for the procedure:)
 

YBYERS

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Thanks for the confirmation. Doc asked and I wanted to make sure I was thinking straight.
 
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