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Wiki Office visit billied with previously booked injection?!?!?!?

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KCOPPENRATH

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So we are having a bit of confusion in our office in regards to billing an office visit with synvisc injections. The doc says On the 1st and 3rd injection he bills an office visit because of the medical decision making of either adding cortisone or not adding cortisone (3rd inj) and states he examines the patient at the first visit so should be able to bill it. Even though the patient was previously examined when they had made the decision to book for the injections. Please Help ?!?!?!?!?!
 
Once a patient is scheduled for a procedure and that is what is being performed then you cannot charge an E&M. If there is something new being done then that is different but not when it is for the same issue.
 
I agree with Debra Mitchell. There is an E/M built into the RVU's of procedures with 0-10 global days. The decision to either use or not use a drug is not significant enough to warrant a separately billable E/M.
 
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