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Can an E&M be billed in place of a sphenocath?

L

lanquockieu

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Renton, WA
Hi all,

For certain minor procedure, if the provider clearly documented time spent, can she bill an E&M instead of the procedure? Our doctor wants to know if she can bill for Sphenocath using an E&M based on time spent since there is no specific CPT code for it. CMS wants an unlisted CPT 64999 with the description for the device used.

Thank you in advance!
 
Absolutely not.

First page, first paragraph of CPT instructs you to report the service that most accurately describes what is being performed. If there is no specific surgical/procedural code you'd report an unlisted code, but never an E&M in place of a procedure.
 
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