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Coding confusion

  1. Question Coding confusion
    Medical Coding Books
    I am a registered nurse performing clinical breast exams in a hospital setting. I am also a member of the AACP, certified in medical coding. Because I don't practice coding at this time, I do not have access to CPT information. I am looking for a code to cover reimbursement for a certified breast exam specialist, not a Nurse Practitioner to perform clinical exams. To the best of my knowledge there isn't one. The facility I work for is trying to find a way to bill for this. I would be grateful for any help you might be able to give me.

  2. Default
    When you say you are in a hospital setting, do you mean you perform this service to patients admitted as in-patient or do you mean there is a breast clinic at the hospital? Everything I have ever seen RN services are incident to the physician or NPP services and are not separately billable. I do not know of any code for a breast exam, it is just part of the physician/NPP service. You might want to look at exceptions for rural/underserved areas if applicable.


  3. #3
    Swainsboro/Statesboro, GA
    Default Exams
    There could be a facility E&M level if this service is performed in the hospital outpatient setting.

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