Really could use your opinion...office can't come to a conclusion

com107

Contributor
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If my doctor does an E&M then decides an in office procedure needs to be done what would you code first, the E&M or the procedure? Or would you code the highest fee first? Example: the E&M is a 99213 and the then doctor decided a 10081 needed to be done, would you bill it in this order: 10081 then 99213-25 or 99215-25 then 10081....or bill first which ever fee is higher, becasue of the reduction in the insurance payment or does it not matter when it comes to E&M codes with minor procedures done on the same day?
Thank you everyone who has helped!!
 

ollielooya

True Blue
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900
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Everett, WA
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In school we were taught to sequence coding in RVU order, whichever code paid the most and go from there. However in the real world, it looks like this process is built into the payer's editing systems to take care of these concerns. I remember a thread on this subject sometime ago, and you'd have to do some searched to try to find it. Our company would bill in your case scenario 99213-25 with the 10081Maybe some others have tried doing both ways and can report on whether or not there was a difference in revenue. Good question...
---Suzanne E. Byrum CPC
 

JMeggett

Guru
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226
Location
Spokane Valley, WA
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For muliple procedures, such as surgery, we put charges in RVU sequence. For E&M with procedure we always put the office visit charge with modifier showing the evaluation & decision to do the procedure 1st...then the procedure.

Jenna, CPC
 
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