Are your doctors employed by the dialysis center? When they are conducting this full-blown E & M, what other organ systems or body areas are they examining? Wouldn't their examination be strictly related to the AV graft and presenting problem? I think you would be shortchanging yourself if you try to bill an additional E & M prior to the intervention. Global days would factor significantly in the processing of your claim, as would appropriate modifier usage.
It has been my experience that AV graft failure tends to compound over time, necessitating numerous returns during the global period. You would have to append modifier -25 to the E & M if done the same day as the intervention. Check your RVUs and be careful to list the major procedure first, as additional procedures will most likely be reduced, if paid at all.
Patricia Hayes, MBA, CPC, CMM, CHCC
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