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Wiki Decison for Surgery on Pacemaker

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tissym2002@att.net

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We have a practice that is billing out a E/M service 99213 with a 57 on the claim line. The patient is having a Pacemaker implant done the next day. My question is does this not need the V code listed as the primary diagnosis or should the condition be listed first? Just want to make sure I instruct our billing dept correctly. Thank you:o
 
tissym2002@att.net said:
We have a practice that is billing out a E/M service 99213 with a 57 on the claim line. The patient is having a Pacemaker implant done the next day. My question is does this not need the V code listed as the primary diagnosis or should the condition be listed first? Just want to make sure I instruct our billing dept correctly. Thank you:o
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modifier 57 is for E/M on the day of or the day before a procedure with 90 days global period. Unless the decision for surgery was made befor this E/M it should be ok.
 
I am going to assume you mean the condition/complication that brought the patient in.... Yes, I would say you should code the codition first for the E/ visit.
 
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