drewvinson23
Networker
Hoping to get some other people's input on this scenario.
I have a physician that recently posted this question to me:
"If I see a patient and do an independent interpretation of a KUB during the global period of an ESWL, is that visit billable?"
Per CMS global surgical package guidelines, my first initial thought would be that this is not billable, as it is related to the recovery from surgery.
However, could this evaluation and management service with the independent interpretation of an image be seen as "treatment for the underlying condition" (the condition being kidney stones), and therefore billable? I have had difficulty finding any guidance or quantifying what constitutes "treatment for the underlying condition." The doctor is interpreting the KUB to see if further treatment will be needed. Is that enough to qualify this as "treatment for the underlying condition" and make this a billable service?
I have a physician that recently posted this question to me:
"If I see a patient and do an independent interpretation of a KUB during the global period of an ESWL, is that visit billable?"
Per CMS global surgical package guidelines, my first initial thought would be that this is not billable, as it is related to the recovery from surgery.
However, could this evaluation and management service with the independent interpretation of an image be seen as "treatment for the underlying condition" (the condition being kidney stones), and therefore billable? I have had difficulty finding any guidance or quantifying what constitutes "treatment for the underlying condition." The doctor is interpreting the KUB to see if further treatment will be needed. Is that enough to qualify this as "treatment for the underlying condition" and make this a billable service?