Wiki Eval for port

hsmith67

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OK,

Two scenarios:

Scenario 1: My surgeon performs a mastectomy on a patient. Shortly after the patient is referred back to my surgeon (or it was in the plan all along) to put in a port a cath for chemo administration. The referral is to meet with the patient, review anatomy and placement of the port, answer any questions the patient may have, etc. and get the port on the schedule.This port referral is during the global post op period of the mastectomy. Is this billable or not?

Scenario 2: My surgeon has a referral for a patient to put in a port a cath. My surgeon has not performed surgery on this patient before (or at least in the last 90 days). The referral is to meet with the patient, review anatomy and placement of the port, answer any questions the patient may have, etc. and get the port on the schedule. Is this visit billable?

Thanks for any guidance!

Hunter Smith, CPC
 
Both are billable, we get a regular patient load from nearby oncologists offices asking us to put ports in. You should be able to use a modifier depending on where the port placement is taking place, such a staged procedure for the first or even modifier 79. On the second, just bill as you would for a new or established patient as long as they are not in a post op period.
 
Sure, it is a different reason for the visit, although not a new patient, is this within the global period? If so use your appropriate modifier. If not, then the visit to talk would be a normal E/M visit code.
 
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