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charging Office visit at same time of wound repair

  1. #1
    Smile charging Office visit at same time of wound repair
    Medical Coding Books
    I was wanting to know if it is legal to charge an office visit with a wound repair when the only diagnosis is for the wound repair

    Thanks

  2. Default
    Remember that in order to report and E/M visit with a 25 modifier you need to have a significant, separately identifiable E/M service. Make sure your documentation support this.

    Monika

  3. Default
    I agree with Monika. Adding to that, I'd personally review the documentation, and if it's supported, bill an E/M with modifier 25 and the wound care.

    Kris

  4. #4
    Question e/m with a repair
    Thanks for the info. I understand about using the mod 25 with the e/m service, but what the doctor was wanting to do was charge an e/m with a simple repair 12001 and the only diagnosis we had was for the wound, so I didn't think it was right to charge the e/m.

    Kind of confused

    kim

  5. Default
    Kim,

    Best way to get unconfused is to get the chart notes, review them and then decide if it's billable or not. Hope that helps.

    Kris

  6. #6
    Default
    Also when using modifier 25,it states different diagnosis are not required for reprting E&M on same date.

  7. Smile Website Info
    Check out this site from EdgeBlast. It kind of helps clarify ( for me anyhow) with some examples of exactly what you are looking at
    http://www.justcoding.com/content.cfm?content_id=209071
    Jaime CPC, NCP, EMR Specialist

  8. Default Same issues with simple repains and reporting e&m
    I'm dealing with the same thing. I work in Urgent cares. A patient comes in and says they accidentally cut themselves. The doctor checks them over and all of that and decides they need a simple repair 12001. Would that call for an E&M and the repair code or is the E&M included in the simple repair code? Now if the patient complains of being dizzy, is that an automatic E&M? Does anyone have any good links that explains all the rules on this?

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