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Thread: Is this billable?

  1. #1
    Join Date
    Apr 2007
    Lehigh Valley

    Default Is this billable?

    AAPC: Back to School
    Good morning!

    Not sure if this subsequent hosp visit is billable prior to surgery.

    The patient was admitted 3/28 with RUQ pain. U/S did not show any cholelithiasis or cystitis. Docs felt it was not due to her GB. She was seen 3/30, 3/31/ and 4/1. It was on 4/1, that her pain worsened after eating and decision for surgery was made on that day and surgery was performed on 4/1.

    No decision for surgery was made on 3/31...notes revealed pt to ambulate and eat a regular diet.

    Is the 3/31/10 still considered to be billable or should I just be billing the 4/1 visit when the actual decision for surgery was made???

    Thanks in advance for your help!


  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default I would bill

    I would bill all the subsequent visits, including 4/01 with decision for surgery -57 modifier.

    Make sure you have good documentation. You will likely get a denial for one or more of these visits and need to appeal with notes.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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