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E/M coded with a procedure - Urgent Care

  1. #11
    Location
    Greeley, Colorado
    Posts
    2,045
    Exclamation
    Medical Coding Books
    Quote Originally Posted by billie View Post
    Thank you for Help on sutures removal.
    Another question for anyone is anesthesia Local when a I&D is done or MRSA wound. We have been using a 00300 or 00400. The Dr's use the code for Lidocraine code J2001 and Epinephrine J0170 is these the correct codes?
    Thanks Billie
    Local infiltration is part of the surgical package. J2001 as an IV code for lidocaine. It would not be appropriate to report anesthesia codes for local anesthesia. See the surgery guidelines on pg 47 of the CPT Professional edition (just before the surgery codes if you don't have this edition).
    Lisa Bledsoe, CPC, CPMA

  2. #12
    Default suture and anesthesia
    I DO agree with NOT reporting the anesthesia. Local anesthesia IS included in the suture and the anesthesia codes 00... are only to be reported by an anesthesiologist and on top of that require a P-status modifier. We usually do not report anything besides the actual suture unless of course there is a E/M visit documented that qualifies to be billed with a 25 modifier.

    My question is when a patient has suture done with another PCP not within our group and comes to our office for suture removal during Urgent Care Business hours are we allowed to bill an Urgent care E/M visit with suture removal dx even though it is whitin the 10days global timeframe?
    **Please reply.


    Thanks

    Marisela Amador CPC

  3. #13
    Location
    Milwaukee WI
    Posts
    4,466
    Default Suture removal by different doctor
    If the sutures were placed by a physician who is not in your group practice, then yes, you may code the appropriate level E/M code for the visit to have the sutures removed.

    F Tessa Bartels, CPC, CEMC

  4. #14
    Location
    San Gabriel Valley
    Posts
    31
    Default E/M same day procedure
    I agree with Kevin.
    You would have to look at it by a case by case.
    Our urgent care will use an E/M along with a seperate proceudre being done same day. Their documentation is supportive. Your mod 25 are for procedures 10 days or less and mod 57 are for your global days 30-60-90.

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