Wiki Need help billing tracheotomy tube change for malfunction of trach

[nagela]

We have a pulmonologist who is doing out patient procedures at the hospital for changing of a tracheotomy tube because the trach has malfunctioned. Because the fistula tract is already established we can not bill 31502. He is not doing an E/M visit at all he just taking them to same day surgery and performing the tracheotomy tube change. We have been trying to bill an unlisted code 31599 but even when we send the medical note it is still getting denied. Does any one have any suggestion?

Thanks,
Amy

 

[blonde01]

From my experience, a tracheotomy tube change is included in an E & M service after the fistula has been formed. Is he seeing the patient in the office the same day? Why is he taking them in surgery? There has to be something else that he is doing besides changing the tube. Can you post the op note without any pt information on it?