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Thread: Cystoscopy. Do I have this right ?

  1. #1

    Default Cystoscopy. Do I have this right ?

    AAPC: Back to School
    Office question: Patient came in for Cystoscopy, do we will for an office visit and a Cystoscopy ??

    My answer:

    If the patient came in for an office visit for the purpose of diagnosis and it was then decided that you needed to do Cystoscopy then you will bill for new patient and the procedure.

    If the patient came specifically for the Cystoscopy (having been referred) that will only allow for the Cysto procedure

    Can you more experienced help me if I correct or not ???


  2. #2

    Default Cysto

    We never do a cysto on a new patient first time visit. We always bring the patient back. We even have doctors office's that tell us the patient needs a cysto but we always see them first and let my doctor decide.

    Hope this helps.

    Wendy R. Weaver, CPC
    Office Manager
    Urology Clinic of South Alabama, LLC

  3. #3
    Join Date
    Apr 2007
    Woodbridge, VA


    If the patient is new and upon examining the patient it was decided a cysto was necessary, it's up to the doctor if he wants to proceed with the cysto on the same day. You can bill for both ov (with proper modifier) and cysto. If the doctor decides to schedule the patient to return for the cysto, then at that visit you would only bill for the cysto. However, if after performing the cysto on that second visit, the doctor's finding indicate there are pollyps or lesions, ets, and the doctor then discusses options with the patient including treatment, etc, that he can bill for an E&M with the proper modifier. As with everything, the doctor's documentation must support the charges.

    Hope this helps.

    Zaida Aquino, CPC

  4. #4

    Default E&M code with cysto

    Do you have any kind of valid documentation that states we can bill an E&M code along with the cysto if the doctor talks to the patient after the cysto and discusses what kinds of treatment is needed and so forth. I am trying to appeal a denial from bcbs they state we cannot bill an E&M code along with the cysto because it is included in the procedure. Anything would help, thank you.


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