• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki New Pt Office Visit&Punch Bx

Create Wiki
H

Hopp

Guest
Messages
228
Best answers
0
Hi there everyone - Just wanted to know if someone would be able to help me coding following: New Pt comes to office with a Susp.lesion and my doc happens to do
punch bx at that time: Documentation: Lesion back suspicious OP: Punch bx
Would I code a new pt visit(25 modifier) along with the Op or do I just code Punch Bx as I thought there was something stating I should only code Op. Thanks for all your help
Deb, CPC (Hoping someone out there can help me as I have gotten different answers re:this)
 
Yes, you can bill both the procedure and an E/M with -25, if you can justify the modifier.

NCCI Policy Manual:

D. Evaluation and Management (E&M) Services

If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure. The decision to perform a minor surgical procedure is included in the payment for the minor surgical procedure and should not be reported separately as an E&M service. However, a significant and separately identifiable E&M service unrelated to the decision to perform the minor surgical procedure is separately reportable with modifier 25.

The E&M service and minor surgical procedure do not require different diagnoses. If a minor surgical procedure is performed on a new patient, the same rules for reporting E&M services apply. The fact that the patient is “new” to the provider is not sufficient alone to justify reporting an E&M service on the same date of service as a minor surgical procedure.

Example: If a physician determines that a new patient with head trauma requires sutures, confirms the allergy and immunization status, obtains informed consent, and performs the repair, an E&M service is not separately reportable. However, if the physician also performs a medically reasonable and necessary full neurological examination, an E&M service may be separately reportable.
 
You must log in or register to reply here.
Top