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Post-Op Care Only

  1. #1
    Question Post-Op Care Only
    Medical Coding Books
    A Patient had an abortion done elsewhere, She came into our office for the post-op care and exam. The physician did a pelvic US to confirm that the abortion was complete and there was no remaining POC.

    I coded this as
    99212 (55) (25)


    This was rejected and is not being paid.

    I could use some help/advice in correcting this claim.

    Thank you!

  2. #2
    Columbia, MO
    The 55 modified is not appended to E&M codes it is appended to surgical codes only. You need to use the surgical code of the surgery performed and append the 55 . You will not bill an E&M at all. Also you need a transfer of care from the surgeon transfer post op to you, without a transfer of care the patient should return to the surgeon, or you bill the patient, or you write off the office visit portion. Also since you did not perform the procedure then do not use the 635 dx code, as this is already done when the patient reaches you.

    Debra A. Mitchell, MSPH, CPC-H

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