Wiki EM/post-op charge Otolaryngology

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KimberlyStewart

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The Dr is billing for an E/M charge during a post-op period for a biopsy of the paratid gland (42410) (ICD-9 527.2,710.2). The Dr and patient made the decison for further surgery during this office visit. He used the diagnosis code of 784.2.

The office visit is related to the biopsy. Should this be a post op visit and not a charged E/M visit.


Kimberly Stewart
Office Manager
 
You could charge an E/m if this office visit documented a new problem. It seems like it is a new problem since further surgery is needed. Not just inflamation, a lesion was found. Don't forget your modifiers on this office visit and also the upcoming surgery!
 
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