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Consult billing on same day as Moh's Surgery?

  1. #1
    Default Consult billing on same day as Moh's Surgery?
    Medical Coding Books
    Hi Everyone,

    I was wondering if it was proper to bill a consult visit on the same day as the surgery. The codes I am billing are:

    99243-25
    17311
    17312 x 2

    Thanks!

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default What is reason for the visit?
    If the patient is being sent to you FOR the procedure, then it's not a consult, it's a transfer of care.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Location
    Columbia, MO
    Posts
    12,527
    Default
    I agree with Tessa, this really looks like just procedure codes are all that is needed, I worked a long time in the Cancer center and never did a patient come in for a consultation and leave with bandages post Mohs. Not even a regular office visit. This is something that is well planned in advance and set up so there should be no visit level of any variety. FYI ... IF on the outside chance that you did have this scenario then you would use a 57 modifier not the 25.

  4. #4
    Default
    I also find it peculiar that the patient comes for a consult and has the procedure on the same day. Did another provider send the patient for an opinion and recommendations? Was the decision to perform the procedure made during this visit? If so, it is a highly unusual setting and will likely promt a review, so if this is all true then make sure your provider documents it appropriately. I have seen the scenario where a patient was sent for a consult to the MOHS specialist and when this specialist decided to go forward with the procedure it was scheduled on a different day.

  5. #5
    Default Moh's and consult same day
    Thanks for the responses everyone. I did forget to mention that my provider does perform consults on the same day as surgery because we are also a freestanding ASC. The referral is sent from another physician and the case is reviewed by my physician prior to the visit. Then the full consult is done same day as surgery because of the combined office/ASC setting. This practice is relatively new, so I was hoping there were other people out there with this same scenario. Thanks alot.

    Jen

  6. #6
    Location
    Milwaukee WI
    Posts
    4,466
    Default Referral
    Jen, you write: The referral is sent from another physician and the case is reviewed by my physician prior to the visit. Then the full consult is done same day as surgery because of the combined office/ASC setting.

    This is not a request for an opinion. This is a transfer of care.

    It's not a decision for surgery, either ... the surgery was already scheduled (i.e. decided on earlier).

    I say no E/M at all.

    F Tessa Bartels, CPC, CEMC

  7. #7
    Location
    Columbia, MO
    Posts
    12,527
    Default
    Tessa took the words right off my keyboard! So I agree no visit at all.

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