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Can you bill a profee for an office visit and lumbar epidural charge?

  1. Default Can you bill a profee for an office visit and lumbar epidural charge?
    Medical Coding Books
    "Can we bill a professional fee for an office visit and the lumbar epidural charge? Our anesthetist provided a lumbar epidural (62311). He also wants to charge for an office visit, 99213. He took a history, did a physical exam, etc. Molina is denying the professional charge 99213? Any ideas? (we are a critical access hospital and not paid by PPS but we do follow the PPS rules)."

    Thanks in advance for any comments or suggestions.

    Shawna Paul

  2. #2
    Unless you can prove that the OV is above and beyond what would be required for the ESI, then no, you can't bill for it separately.
    Walker Bachman, CPC, CPPM

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