Please see responses in blue.
Scenario 1: The physician would only bill for the surgery. Pre and postoperative care including admission/discharge unless the E/M resulted in the decision for surgery, which you would append modifier 57 to the E/M and bill the surgery. Prior to laparoscopic appendectomy, surgeon examines the patient according to the E&M notes, patient to be discharged on same day. Physician has billed 99219 and 44970. If patient was admitted and discharged on the same day, wouldnâ€™t a 99234-99236 be the appropriate code?? I need some confirmation on this.
Scenario 2:Yes this is fine, given the documentation supports both services. However, some payers might want the 57 modifier instead of 25, check with your payer.
Physician is called by the ER for a consult after attempted failed treatment of metacarpophalangeal dislocation by ER doc. Physician bills 99243-25 and 26715. Is this appropriate?
Scenario 3:I would consider the 4 days to be postoperative and included in the global period.
Patient has an enterectomy(44120) for enteritis, intestinal obstruction & complication of colostomy and is in-patient for 4 days after the procedure. Can the surgeon bill 99231 for each day that they see the patient for a related dx of diverticulosis?? Would the subsequent hosp visit be considered part of the global period of 90 days post op?
Hope that helps...
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