Ectopic Pregnancy Question

ELBrock

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Patient was seen in the office by Provider A to confirm pregnancy. A Urine HCG test and Ultrasound are done. Due to patients symptoms of syncope and hypotension, the patient was sent to the ED. While in the ED, Provider B of the same practice as provider A, admits the patient to surgery, where treatment of the discovered ectopic is undertaken. The patient is discharged home the same day.

The E/M visit from Provider A is not separately billable, correct? Since Provider A and B are billed under the same Tax ID, we couldn't have a new patient office visit and then the surgery the same date? CPT 59151 has a 90-day global period, which would go back to one day prior to the surgery.
However, I can bill for the Ultrasound and HCG test done in the office, right?

Thank you for your help!
 
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You can definitely bill for the ultrasound and HCG. The office visit and ER visit are bundled together. Since it appears the visits were the decision for surgery, a visit does seem billable with modifier -57. We would typically bill the ER visit and just post a no charge on the office to clear the encounter. IF the office visit was the decision for surgery, then I would bill the office visit instead of the ER visit. From what you provided though, that does not appear to be the situation.
Hope that helps!
 

ELBrock

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Thank you for your response csperoni! That makes complete sense. Yes, the decision for surgery was made in the emergency room. I will have to look again to see if our Hospitalist consulted with the ED provider prior to surgery, in which case I could bill the OP consult code with modifier 57 along with the Procedure Code?
Thanks again!
 
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