View Poll Results: Does your Facility have an Open Access GI Lab?

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  • Yes

    1 33.33%
  • No

    1 33.33%
  • Use to but not anymore

    0 0%
  • At my old Facility

    1 33.33%
  • Other: please explain

    0 0%
Results 1 to 3 of 3

Census on E/M Services Following Open Access Scopes in GI Lab

  1. #1
    Urbana, IL
    Post Census on E/M Services Following Open Access Scopes in GI Lab
    Exam Training Packages
    The GI Providers at my Clinic have asked for a search to retrieve information pertaining to office visits following Open Access Scopes performed at the request of Patient's PCPs. I have brought to their attention that their visits following the Open Access scopes (a.k.a Professional Services) must be reported with an established patient code from series 99212-99215. In return they asked to have a census of Clinics nation wide to review the operational practice of the cognitive evaluation should the Open Access scope result inconclusive. Here are the specific of the situation at hand: Patient presents to PCP with Abdominal pain. PCP requests Colonoscopy through Open Access GI Lab. Scope is performed by GI Provider. Scope is inconclusive and GI Provider requests that the patient be scheduled with other GI Provider within the Practice for a cognitive evaluation of a patient. This visit in their mind would constitute as a consult whereas CPT Nomenclature in both CPT 2008 and The Principals of CPT, 5th addition state otherwise. Any thoughts or specific documentation that folks could share would be greatly appreciated!! –Dawn
    Dawn Peterson
    Coding Consultant/Billing and Coding Instructor
    Illinois, USA

  2. #2
    Is the 2nd GI more specialized? That is the only way I can see a consult actually being appropriate. Otherwise I agree that this would just be an established patient. I have worked with several GI's in a group practice setting and this has never happened before in my personal experience.

    The only time the GI's sent patients to another GI it was always outside our practice to a someone that was more specialized.

    Good luck with your survey

    Laura, CPC

  3. #3
    Urbana, IL
    Thanks for your response and kind words Laura,
    The 2nd GI provider often used is one of the PAs for the department. The reason appears to be operationally more efficient to have the patient schedule with the PA as appose to needing to consult a more specialized Provider. -DP

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