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Thread: Mdm

  1. #1
    Join Date
    Apr 2007
    Springfield, Mo

    Default Mdm

    AAPC: Back to School
    Could I get some opinions on this please? Dr. Makes a decsion for SX at one visit and brings the patient back in later for a "surgery consult" at which he goes into greater detail about the SX, including possible complications and p.o. instructions. Can he take credit for the MDM at the second "SX consult" appointment? Or do we have to base the level of service on the history and exam only? He feels he should get credit for the extra explanations and details.
    solocoder CPC

  2. #2
    Join Date
    Apr 2007


    was the first visit and surgery consult done on the same date?

  3. #3
    Join Date
    Apr 2007


    To be honest, unless there is new diagnostic information or patient options are still in the air, we dont allow billing for that visit after the provider decides on surgery.
    Many times they come in after the decision and our providers will give them a full exam and go over the risks/benefits and we consider that to be "global" whether its 24 hours or more out from the surgery.

    Once the decision has been made, then anything pertaining to that we just dont allow until the billing of the surgery. (there will be, of course, extenuating circumstances...but they are rare)
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

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