Wiki Podiatry billing in Nursing homes

[radwanmalas]

Hello we have a podiatrist that goes to nursing homes we were told by her that she cannot bill an E/M code for each pts she sees unless it is a eval or readmit.
She sees sometimes 30 pts in one day but bills only the procedures that pay about $30 and about 1 or 2 visits codes for a pt or 2.
Is that the norm? or is it possible for her to bill an E/M code for each visit but perhaps at a lower level of complexity?

 

[thomas7331]

Hello we have a podiatrist that goes to nursing homes we were told by her that she cannot bill an E/M code for each pts she sees unless it is a eval or readmit.
She sees sometimes 30 pts in one day but bills only the procedures that pay about $30 and about 1 or 2 visits codes for a pt or 2.
Is that the norm? or is it possible for her to bill an E/M code for each visit but perhaps at a lower level of complexity?

That's not entirely correct - an E&M can be billed if the documentation supports it and the service is medically necessary (and if a modifier 25 is supported in the event that a procedure was also performed). But the provider cannot automatically bill an E&M code for every patient. If the provider is just performing a procedure on a patient who was evaluated at a prior visit and does not have any new problems or complaints, and the provider is not managing any other unrelated medical problems at that same visit, then a separate E&M code during that same visit is most likely not supported.