valariej
Networker
I have a physician who schedules a pt for an outpt procedure at the hospital. There are no global days for the procedure. (stent placement)
Pt is an outpt surgical pt status according to the hospital. Pt is not admitted as OBSV nor is there a written order by the physician to admit the pt to OBSV.
Physician wants to bill an OBSV code with modifier -25 in addition to the procedure because the hospital requires him to do an H & P prior to the procedure and because he is Observing the patient after the procedure.
I, say, "no", this is not a separate identifiable e/m and thus is included in the payment for the procedure. He states another coder says this is a "grey" area and it can be billed in addition to the procedure because the procedure does not have any global days.
All the research I have done states doesnt matter if there is zero, 10 or 90 global days, it cant be billed.
Please give me your feedback. What would you do???
THANKS MUCH!!!!!:
Pt is an outpt surgical pt status according to the hospital. Pt is not admitted as OBSV nor is there a written order by the physician to admit the pt to OBSV.
Physician wants to bill an OBSV code with modifier -25 in addition to the procedure because the hospital requires him to do an H & P prior to the procedure and because he is Observing the patient after the procedure.
I, say, "no", this is not a separate identifiable e/m and thus is included in the payment for the procedure. He states another coder says this is a "grey" area and it can be billed in addition to the procedure because the procedure does not have any global days.
All the research I have done states doesnt matter if there is zero, 10 or 90 global days, it cant be billed.
Please give me your feedback. What would you do???
THANKS MUCH!!!!!: