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Can a physician bill for a new patient visit and thoracentesis and tunneled cath in the office on the same day with full reimbursement? I know the ov would need a modifier -25. Would I also need decision for surgery modifier? Sometimes the surgery decision would be made the day of and sometimes not. Does the same hold true if patient see in office and then does thoracentesis as outpatient in cancer center? What about suture removal on a different patient? I know it is included in surgery code but if different surgeon would I just need the modifier on suture removal code stating not the operating surgeon?


Kansas City MO
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I realize this a very late reply; hopefully you were able to find answers to your questions by now. If not, here goes...
You can bill for a thoracentesis and tunneled cath on the same day IF they are opposite sides, which you would indicate with the application of a -59/rt/lt modifier (depending on your payor). If they are on the same side, only bill the cath. A -25 modifier is all that is needed for the E/M as neither of these procedures have a global period. A decision for surgery modifier (-57) is only applicable to procedures with a 90 day global.
Removal of sutures on a patient that your physician did not perform the surgery on is billed with an E/M code though provided there is sufficient documentation to support the visit. There is no code just for suture removal.