Pain Specialist-- New at Billing

Messages
6
Best answers
0
Hi guys, I currently code for a Pain Specialist and he does Follow up appts 1 day and procedures another day. Never on the same day. We are getting a neurosurgeon to replace our pain specialist who will be doing the same procedures(and a lot more).

My question is, the neurosurgeon does Office visits and some procedures on patients the same day. If all I have is one diagnosis(say they came in with low back pain and same visit he decided they needed to shot in the back), is there a way of getting paid for both? :confused: He has told us that he has done that forever and that we can get paid for both but from my coding experience, if there is a procedure, we would have to have another dx to use in order to get paid.

Thank you.

Kelly Armstrong, CPC :)
 
Messages
252
Location
Albany
Best answers
0
If a patient is seen by the physician and a decision is made to do a procedure you can bill for the office visit by appending a 25 modifier on the E/M code. The diagnosis code for the procedure may be the same as the one for the visit if it is indeed the true diagnosis code. Be leary of insurance policies however that only reimburse procedures with certain diagnosis codes. For example, Medicare will only pay for a lumbar epidural injection with a list of diagnosis codes that support medical necessity. Do you research prior to ensure you document and bill appropriately.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
 
Top