scopes w/ new pt visit

sundaey

Networker
Messages
68
Location
Las Vegas
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0
We have an ENT doc that scopes every new pt that walks in the door. Can you bill for both the scope and the new pt visit with a -25?
I dont think that he should get both b/c it's not significant or separately identifiable/nor is it above and beyond the normal scope for him, however, my boss doesn't agree.

I would appreciate any feedback.
 

efrohna

Guru
Messages
115
Location
Appleton
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0
If your ENT provider is only documenting the scope procedure, then you are correct no New Patient Visit should be billed in addition to.

However, if the ENT provider is documenting ALL 3 components of a New Patient Visit: History, Exam & Medical Decision Making, AND the scope procedure, you may bill for both. Don't forget the 25 modifier on the E/M.

Documentation is key, especially the medical decision making!
E. Frohna
 
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