Wiki Coding a visit in the hospital the day before a surgery?

[marci_ann]

Hi, what code would we use for a visit by the surgeon to a patient who is currently admitted in the hospital and they are having a procedure by that surgeon the next day? The procedure is normally with a 90 day global, and since that visit is considered part of the "global package" since it's the day before a procedure, what do we use? I'm asking this on behalf of a fellow coder, who was using 99024. Please help. Thank you.

 

[pam claspill]

E&M day before surgery

If this visit is where the decision to perform surgery is made use the level of E&M documented with a modifier 57. If this is just the surgeon introducing himself and going over what to expect of the surgery then nothing should be billed.

 

[pkidd]

coding hospital visit on day prior to surgery

Hi Marci,

Agree with Pam: If the surgeon is visiting the patient just to do another PAR-Q interview or talk about the upcoming surgery, you cannot bill for that visit. Our practice calls these "Howdy visits".

However, if the surgeon sees the patient in order to assess his/her readiness for the procedure, you can submit a claim to the payer. Append mod-57.

I am wondering tho' why your co-worker chose cpt 99024. Is the patient already in a global period?

If so, carefully review the surgeon's documentation. You may be able to receive reimbursement for this. Patient must be inpatient otherwise, Medicare won't cover the charge. You will also need to append modifer 24 in addition to modifier 57 on the e&m code.

Anyone.. other ideas??

Hope this is helpful! If need clarification or if I did not explain this very well, please feel free to contact me directly.
pat kidd, cpc, cgsc
pkidd@samhealth.org