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Consult with Scope

  1. Default Consult with Scope
    Medical Coding Books
    If a patient comes in for a new patient consult and then requires a scope, but the doctor only gives one dx.... Can we bill the consult with the scope with a modifier 25??? Is there any links/information you can send to me.



  2. #2
    Columbia, MO
    Yes you can! In the CPT book in Apendix A look at definition under the 25 modifier. It states"As such separate dx are not required...."

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    If the decision for surgery was made at the time of the initial consult and the scope has global days of 90, 57 modifier may be more appropriate.

  4. Default
    Michellede is absolutely correct, as long as your documentation supports an E&M as well as the scope, you can bill the E&M w/Mod. 25 & the scope with one diagnosis; Mod. 57 w/b inappropriate in this scenerio.

    CT ENT

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