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Thread: Pre op Consult w/Office visit

  1. #1
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire

    Default Pre op Consult w/Office visit

    AAPC: Back to School
    Provider has a pt that is having spetoplasty turbinectomy. Pt sent for "preop consult". Provider also sees pt for 3 other new onset dx and prescribes medication. Can 99243 be used with 99213-25?
    Thank you
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  2. #2
    Join Date
    Apr 2007


    I'm not an E/M expert by any means but as far as I know, you can only bill one E/M code per visit.

  3. #3
    Join Date
    Apr 2007
    Duluth, Minnesota


    if documentation supports both services you can split bill it as you have it, with a modifier on the 99213. But documentation has to be able to "stand alone" and support each visit separately. (when our providers do this we have them dictate separate notes to support each service) The consult is going to need to meet all 3 components and the 3 R's - (request, render, report), and the level 3 E/M will need to stand alone in it's services. It might be kind of difficult to pull out a level 3 consult AND level 3 E/M. You could probably pull out a 99242 & 99213.25 or visa/versa - 99243 & 99212.25. If documentation doesn't support both levels - independently of the other, well - then you only have one service.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

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