Wiki Office visit results in same-day admission for O/P surgery

[monica@shevell.net]

Patient comes in for a lap band aspiration due to nausea/vomiting and pain. The lap band had slipped and the patient had to be scheduled for same-day outpatient surgery. What E/M code / modifier / POS combination would I use to code this in order to account for all of the work involved in getting the patient scheduled for emergency surgery?

 

[amar1727]

There are 2 options here:

#1. Append a Modifier 25 to your Office EM code. Also append Modifier 78 to the procedure code, if the patient was still in the post operative period and if the same physician is performing the correction to the band.

#2. The EM can be included in the procedure as part of Pre-op evaluation. Depends on the patient's insurance carrier. Contact your Provider Relations representative or the insurance carriers Utilization Review department directly for clarification.

Hope this helps.