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Wiki doctor orders a procedure for next visit

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Jennifer17

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I am new to pain management, and my doctor sometimes sees a patient for an initial visit, and depending on their insurance may order a procedure to do at the next visit while we obtain the authorization- when the patient returns our physician wants to bill an E/M code along with the procedure- I always thought if was planned, can only code the procedure, he says he evaluates the patient again, exam etc , to determine if in fact he is going to do the same procedure and if he does he wants us to code an E/M- please advise..........
 
If the are specifically coming in for the procedure the E&M is bundled. It would not be significant and separately identifiable. There would have to be a material change in the patients condition to warrant another E&M.
 
sorry but another question I have - when would you ever code 72275 epidurography- he wants to bill it with every procedure he does and from what I see, its a misuse of that code- so when is it appropriate to ever use this code? Thanks!
 
[FONT=&quot]Epidurography should only be reported when it is reasonable and medically necessary to perform a [/FONT]diagnostic study. It should not be billed for the usual work of fluoroscopy and dye injection that is integral to the injection(s)

This is based on AMA CPT guidelines:


(For injection procedure, see 62280, 62281, 62282, 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484)


(Use 72275 only when an epidurogram is performed, images documented, and a formal radiologic report is issued)
 
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