Wiki 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!
 
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!
 
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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