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Split visit consultation questions??

  1. #1
    Default Split visit consultation questions??
    Medical Coding Books
    Hi everyone:

    I am coding this visit for a family physician (Healthkeeper insurance patient) she is trying to bill a consultation along with an office visit, I advised her that two E/M code can not be bill for same Date of Service. Where can I direct her so she can have this info in black and white?

    Reason for consultation is to get a foot surgery and reason for office visit is because patient is requesting depo injection, now if Dr. decided to bill the consultation only, should I append a mod 25 to consult and bill the pregnancy test and the depo injection? Thanks to all for your help.
    Mildred Nieves, CPC

  2. #2
    Columbia, MO
    I do not get the consultation on this. If the foot surgeon is asking for medical clearance then this is not a consult it is an office visit. You do not have the 3 Rs to be able to justify a consult. There is nor request to have your physician render a decision or an opinion on something unknown. The foot surgeon is asking for a medical evaluation of your patient that you see on a regular basis. The determination for surgery will be made by the surgeon. It should be an office visit with a 25 and an injection admin code.

    Debra A. Mitchell, MSPH, CPC-H

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