Wiki Varicose Veins Phlebectomy

[TPodsednik]

My physician is wanting to put a time limit on doing varicose vein phlebectomy. Breaking it down in 1 hour sessions instead of completing the procedure. I am not sure how we would document this without it looking like we are doing the same veins over.

 

[danskangel313]

There's a number of issues here, aside from the fact the codes aren't meant to be time-based. In theory, if a procedure is discontinued, you add a 52 mod for reduced service, but the fact that procedure isn't being completed simply because the provider decided spending one hour was long enough makes even a 52 questionable.

This raises HUGE red flags left and right. The very first thing I thought after I read your post was "fraud". By stopping and restarting and stopping and restarting, you'll end up with the same code over and over and over. Anyone could easily make a case that this practice of stopping and starting intentionally will fraudulently drive up reimbursement for the provider. How would the provider prove that that wasn't the motive?

If it were me, I'd avoid this at all costs.