Self Pay Cases

yolwil

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Jackson, MS
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I have a cosmetic case that cancelled after preop exam but before induction. Do I bill an E/M code or the time? The anesthesiologist is telling me that no E/M code is needed because it is self-pay. I'm thinking that I should bill the E/M code because the surgery never started due to patients afib with uncontrolled rate. Are rules different for self pay cases?
 

CodingKing

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Discontinuation of anesthesia before drug administration would be an E&M regardless of patient status insured vs non-insured. You cannot waive charges in a self pay patient if you wouldn't waive charges to an insured patient.
 

yolwil

Networker
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Jackson, MS
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Thanks, that is what I thought but I wanted to make sure before I informed the docs that, that is not correct. They are wanting me to bill the time which was 42 minutes, which would probably cost wise be more than just the E/M. I'm trying to make sure that I do what is legally right. I know that I'm going to get some push back from them on this. I know they will want to see this in writing somewhere.
 
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