You cannot bill both the office visit AND the H&P on the same date of service. CPT tells you to roll all the work done together to determine your level of service for the H&P.
An E/M on the day of or day before surgery is included in the global package (unless it's the decision for surgery)
Given the limited info you'd stated, I'm gonna guess that the decision for surgery is made at the office visit (new patient). So I'd code the 99201-99205 with a -57 modifier (or -25 depending if procedure is minor or major surgery), and I wouldn't code the H&P at all. Course, I'd be willing to listen to arguments for coding the Initial Hospital visit with the -57 modifier ... it's just that this sounds to me like the decision for surgery was made at the office visit.
Just my humble opinion.
F Tessa Bartels, CPC, CPC-E/M
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join