Consult and Procdure question

dmccullers

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One of my doctors asked me the other day if he does a consult on a patient to determine if a procedure is needed can he bill for a consult and a procedure on the same day? I told him that I did not think we could bill for both. Who is correct?
 

mitchellde

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It just depends on the documentation. To bill for both the documentation must be significant and separately identifiable, meaning over above and beyond was is required to be able to perform the procedure, and still medically necessary. Every procedure has included the reimbursement for the assume that is needed to be able to performe the procedure. For any given patient, at any given encounter, either of you is correct.
 

nlbarnes

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Separately identifiable E/M NEED HELP STAT!

Hello all - I still need help STAT as I'm told to submit charges (E/M-25 & procedure in office) that the doctor enters in addition to a procedure and I am told that I am not liable even when the patient wasn't seen for another reason.

Also, I read in a Business Monthly issue that a new patient (doesn't have another reason for being seen) doesn't necessarily warrant and E/M along with the procedure.

Can anybody direct me to documentation that states I am absolved, not liable, or more importantly lose my certfications for just "submitting" the claim?
 
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