cmoegelin
New
Hi there! I'm not seeing anything addressing this particular issue, so I'm trying to get some feedback on how you all code this. We have providers billing it as a level 5 visit, but they are sending the patients back to their PCP for clearance and to order the required testing ([labs and EGD] rather than ordering it themselves). The patient does determine which procedure they are in and they do start the authorization process with insurance after this visit, but the doctor also has the patient come back in to review all of the testing and to schedule surgery. I don't think the first visit should be considered the decision for surgery and coded that high as they have still have to complete "clearance" with psych and whatnot. That being said how would you code the first visit? How about the second?