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Office Visit and Procedure

  1. #1
    Default Office Visit and Procedure
    Medical Coding Books
    4/1/09 Level III billed for Infected Toenail. 5/1/09 patient returns w/ cellulities of toe and cauterization was performed; proud flesh. 6/16/09 patient returns w/ paronychia L toenail, Partial L toenail removal w/ ablation. Provider believes they should not charge any office visit for 5/1 or 6/16, only for the procedures. Shouldn't they also charge for at least a level II office visit in addition to procedures? Thanks!

  2. #2
    Milwaukee WI
    Default Procedure RVU includes E/M
    The RVUs and payment for the procedure already include the basic E/M required for the procedure.

    You should charge an office visit ONLY (BIG ONLY) if there is a significant, separately identifiable E/M service performed this same date of service.

    For example: If on 6-16-09, in addition to the LEFT toe, patient also complained of nail fungus on RIGHT foot (no procedure on right, just E/M).

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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