Wiki Follow up after breast biopsy?

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GIBBERS

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WE HAVE A PATIENT THAT HAD A BREAST BIOPSY, CPT 19125 WITH THE DX OF BREAST MASS 611.72. THIS SURGERY HAS A 90 DAY GLOBAL PERIOD

THE PATH REPORT CAME BACK AS BREAST CANCER AND THE PATIENT CAME IN FOR AN EXTENDED VISIT FOR THE SURGEON TO GO OVER THE PATH REPORT AND TO DISCUSS THE UPCOMING SURGERY.

CAN I CHARGE FOR THIS VISIT SINCE THE PATIENT NOW HAS A DIFFERENT DIAGNOSIS? MY INSTINCT IS TELLING ME THAT IT IS A POST OP VISIT REGARDLESS, BUT THEN I MAY BE WRONG.

THANKS FOR YOUR HELP!:confused:
 
I would code it by the path report. You might want to look at the modifier 58 with the office visit. I will be interested in the other replies.
 
You cannot use a 58 modifier for an office visit code, and the dx of breast mass is not truely a different dx it was a symptom of the diefinitive dx of breast cancer, what you have is a post op encounter which is part of global and not billable.
 
Wouldn't the visit after the bx be the visit to have more surgery because of the diagnosis? Now, a plan has to be made.
 
It is, however it is still part of the global, just the same as complications are a part of global. I really see no way around it. In the Cancer Center, after the surgeon received the results, he would send the patient to the oncologist for the discussion of the future which could be billed by the oncologist. However for the surgeon it is global.
 
mitchellde said:
You cannot use a 58 modifier for an office visit code, and the dx of breast mass is not truely a different dx it was a symptom of the diefinitive dx of breast cancer, what you have is a post op encounter which is part of global and not billable.
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I totally agree. Discussion of the path report is directly related to the surgical procedure and is therefore not billable.
 
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