Coumadin & office visitbilling - help!

ridenut

Networker
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62
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Silver Spring, MD
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:eek:PATIENT WAS SEEN BY THE DOCTOR TODAY FOR A MID YEAR CHECK UP AND ALSO HAD BLOOD DRAWN FOR COUMADIN TESTING (SENT TO OUTSIDE LAB).
MAY I BILL FOR AN E/M CODE AND 99363 WITH 36415?

ALSO,
PATIENT COMES IN FOR BLOOD WORK ONLY WHICH IS SENT TO THE LAB FOR RESULTS THEN THE DOCTOR CALLS THE PATIENT TO GIVE RESULTS. OUR OFFICE IS CURRENTLY BILLING JUST THE 36415 ON THESE VISITS = CORRECT?
 

mitchellde

True Blue
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13,538
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Columbia, MO
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Using the 99363/99364 with an E&M is allowed by AMA conventions using then a 25 modifier on the E&M, However Medicare as well as most other carriers have stated they will not allow this and will pay the lesser of the 2.
and yes you can bill only the 36415 or 36416 for a blood collection encounter.
 

ridenut

Networker
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62
Location
Silver Spring, MD
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ok - thanks - if I understand then it would be either e/m or the 99363/99364 code?

on bloodwork only visit:
If our nurse is taking the blood, we send it to the lab we code 36415... if the provider interprets the lab results and calls the patient with instructions is there a code we can use for the provider's service?
 
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