Hello! So sorry this will be long winded! I am a coder for OBG and I know that 2 e/m codes can't be billed on the same DOS unless separately identifiable. However, one of our practitioners is convinced that this is untrue because she "knows for a fact that other offices aren't just giving away free services" and "every other offices does it somehow, and I just never have heard this before". (I very much know that it is not untrue and that she must be mistaken in some way.)
So, the first appointment is a 1 hour spot with the nurse, where the nurse does vitals, gets a full medical history, screens the patient for drug/alcohol/domestic violence by friends family or self, goes over all of the literature in the new patient packet, explains resources for assistance, etc etc. After that, patient then sees the provider for their initial OB visit. The practitioner is very adamant that there must be some way to bill for an hour worth of the nurses face-to-face time on top of the provider e/m (we are a mostly medicaid/self pay/financial assistance clinic and rarely have global). It would not qualify for a higher level e/m or prolonged services because the hour of face-to-face time is solely with the nurse. I do bill the drug/alcohol screening, but that is a maternity initiative which only makes up about 2-3 minutes of the hour.
Is she correct in saying that there is some way to bill this? I feel like she must have perceived something she heard incorrectly. I have searched high and low for prenatal screening HCPCS, CPTs, etc. and I cannot find a THING that supports billing the hour long nurse screening & education in addition to the provider OV. So, I am continuing to approve only the e/m that supports the level of service indicated by the physician in his/her chart note, and not taking the nurse visit into account. I feel like that's correct, but an hour is a long time to dedicate for no reimbursement, so I just had to make sure. Thanks in advance!
So, the first appointment is a 1 hour spot with the nurse, where the nurse does vitals, gets a full medical history, screens the patient for drug/alcohol/domestic violence by friends family or self, goes over all of the literature in the new patient packet, explains resources for assistance, etc etc. After that, patient then sees the provider for their initial OB visit. The practitioner is very adamant that there must be some way to bill for an hour worth of the nurses face-to-face time on top of the provider e/m (we are a mostly medicaid/self pay/financial assistance clinic and rarely have global). It would not qualify for a higher level e/m or prolonged services because the hour of face-to-face time is solely with the nurse. I do bill the drug/alcohol screening, but that is a maternity initiative which only makes up about 2-3 minutes of the hour.
Is she correct in saying that there is some way to bill this? I feel like she must have perceived something she heard incorrectly. I have searched high and low for prenatal screening HCPCS, CPTs, etc. and I cannot find a THING that supports billing the hour long nurse screening & education in addition to the provider OV. So, I am continuing to approve only the e/m that supports the level of service indicated by the physician in his/her chart note, and not taking the nurse visit into account. I feel like that's correct, but an hour is a long time to dedicate for no reimbursement, so I just had to make sure. Thanks in advance!
