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I need everyone's thought on this.....

  1. #1
    Location
    Madisonville Pennyrile; KY Code Miners
    Posts
    37
    Default I need everyone's thought on this.....
    Medical Coding Books
    I code for a plastic surgeon. I double checked this with my supervisor, who assures me I am correct. He does a lot of 17110 cryo destruction of a lesion. Ok, pt comes to first visit. Doctor codes a E/M visit with a (-25) and codes 17110. In his assesment he states to see the pt back in two weeks for re-examination and possible refreezing.

    I have told him that on that second visit, if he refreezes the lesions he cannot code a E/M because he knew the pt was coming back for this. But if he does not refreeze then he can code a E/M. Just a note the pt is normally out of the global period.

    Please let me know your thoughts on this. Thanks.
    Charlotte Lynn, CPC, CPC-H, COBGC
    Baptist Health Madisonville Women's Care
    Madisonville Pennyrile Chapter
    KY CODE MINERS
    Madisonville, KY

  2. #2
    Default
    I agree that is correct but I question the motive.

    The part that I question is the routinely bringing them back after to the global period to do a re-exam. Is that on purpose just so an E/M can be billed again?

    I don't have providers that do this procedure very often so it is not an issue I have ever dealt with. It just seems suspicious to me that they are brought back after the 10 day global for the recheck and charged an office visit to tell them they are fine.

    Just my opinion,

    Laura, CPC, CEMC

  3. #3
    Location
    Madisonville Pennyrile; KY Code Miners
    Posts
    37
    Default
    He tells all his pt's to follow up after two weeks reguardless of what is done. But he has always marked both. I just have always removed the office visit if needed. I guess he finally figured out what I was doing. Or someone told him he couldn't do that. Not sure, I just wanted to make sure I was doing the correct thing, before continuing. Plus he didn't like my answer and wanted a second opinion. So I told him I could post on here and ask other coders how they handled this. Thanks for the input.
    Charlotte Lynn, CPC, CPC-H, COBGC
    Baptist Health Madisonville Women's Care
    Madisonville Pennyrile Chapter
    KY CODE MINERS
    Madisonville, KY

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default 2-week follow-up vs. 10-day global
    I agree with Laura ... It strikes me as odd that all his patients are asked to come for a follow-up two weeks post procedure, just as the 10-day global has expired.

    Frankly, I think that first follow-up visit should be 99024, even though, technically, it's outside the global. We routinely code this way for patients who can't get a follow-up appointment within 10 days, but don't exceed 20 days. It's the right thing to do, I think.

    That being said, Charlotte, your understanding is perfectly correct. If he's going to do a procedure and he knew he might be doing a procedure he can't charge an E/M service, as that is part of the fee for the procedure.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  5. #5
    Location
    Madisonville Pennyrile; KY Code Miners
    Posts
    37
    Default
    Thank you Tessa. I appreciate your feedback. I do give the pt's a 99024 if they are close to that 10 period, even if it's outside of the 10 day by a couple days. But I was not giving him the E/M if he did a 17110, and knew thats why they were coming back. I did tell him yesterday the couple people I have heard from on this, agree with me. He said OK, but I don't think he was happy about it. Anyway thanks again.
    Charlotte Lynn, CPC, CPC-H, COBGC
    Baptist Health Madisonville Women's Care
    Madisonville Pennyrile Chapter
    KY CODE MINERS
    Madisonville, KY

  6. #6
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    How about a preventative visit with 17000 and an office visit?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  7. Default
    Quote Originally Posted by kbarron View Post
    How about a preventative visit with 17000 and an office visit?
    Kbarron...first of all you cannot even begin to code that as a preventative visit.... it is a known problem... secondly 17000 is for premalignant lesions, not benign

  8. #8
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    would you have a link to that...They want to see it in writing....
    Karen Barron, CPC
    Hampton New Hampshire Chapter

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