codewrangler
New
I’m a coder but haven’t worked in a specialist practice before, and I have a question regarding billing related to an in-office procedure.
Someone I know had a 12-core prostate biopsy in his urologist’s office. He got a bill from the pathologist and another one that said “lab pathology general” with the biopsy date. When the number on the 2nd bill was called, the person on the line said the bill was not for the urologist, who would bill separately, but for the facility/staff/equipment/cleaning. The urologist is part of a hosptal-associated specialist group, but they are not located in the hospital proper and records have to be requested from the practice directly and not through the affiliated hospital.
My question is this: Shouldn’t the urologist bill with POS 11, and wouldn’t the associated RVUs for the physician’s office where he schedules regular patient visits compensate for staff/equipment and the like? This seems like unbundling to me, but I don’t feel expert enough to say for sure.
Thanks for weighing in!
Someone I know had a 12-core prostate biopsy in his urologist’s office. He got a bill from the pathologist and another one that said “lab pathology general” with the biopsy date. When the number on the 2nd bill was called, the person on the line said the bill was not for the urologist, who would bill separately, but for the facility/staff/equipment/cleaning. The urologist is part of a hosptal-associated specialist group, but they are not located in the hospital proper and records have to be requested from the practice directly and not through the affiliated hospital.
My question is this: Shouldn’t the urologist bill with POS 11, and wouldn’t the associated RVUs for the physician’s office where he schedules regular patient visits compensate for staff/equipment and the like? This seems like unbundling to me, but I don’t feel expert enough to say for sure.
Thanks for weighing in!