Pessary fitting and insertion done at 2 different office visits

msnbabs001

Contributor
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I am looking for guidance on how to bill an office visit that is for a pessary fitting only as well as the insertion visit that is a week later. I know there is 57160 but the description is fitting and insertion.
Do you bill the fitting visit as E/M based on the documentation and then for the insertion visit bill as 57160 and A456_? Or would you bill each visit as 57160 with a modifier for reduced services(52)?

I appreciate any input.

Thank you,
Barb
 

TYSON1234

Guru
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I always bill the fitting as an E/M and when they come back for the insertion you bill the insertion code.
 
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pamvh

The code description is "fitting AND insertion". How can I bill the 57160 if it is only fitting OR insertion. It appears to me that I should only be able to bill the 57160 if the pessary is fitted AND inserted at the same visit. An E/M code would be used if only a fitting OR only an insertion occurs in a single visit. Am I wrong?
 
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