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Re: Billing question From: Ronald Anisworth (ainsron@sbcglobal.net) Tue May 6 21:46:49 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ronald Anisworth: "Re: OB: Planned Home Birth After Previous Cesarean" Previous message: Henry Gregor: "Re: Billing question" In reply to: Larry Glazerman: "Re: Billing question" Next in thread: Larry Glazerman: "Re: Billing question" Reply: Larry Glazerman: "Re: Billing question" According to my coding manual, the definition of -25 says: "Significant and separately identifiable. This phrase is important when reporting an E/M service provided on the same day as a procedure. Physicians can report both services only when the E/M service is "significant and separately identifiable." The physician must obtain and document a history, physical examination, and medical decision making at a level sufficient to justify reporting both an E/M service and the procedure." To my mind, the implies separate diagnosis codes, how else can the insurer identify them as separately identifiable? If the visit was for the decision to perform surgery on the same day as the procedure, you could use -57 with the same code. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Larry Glazerman Sent: Tuesday, May 06, 2008 2:47 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Billing question Ron: I don't think that's quite true - you can have two separately identifiable services related to the SAME ICD9 code. For example, if a patient comes in for abnormal bleeding, you get a history, examine her, go through decision making, there's an appropriate E&M code. If you decide to do an endo biopsy at that visit, it can be billed too, using the same ICD9 code, with a -25 modifier. I think the modifier actually goes on the E&M code rather than the procedure, but I could be wrong. Larry R. Glazerman MD St. Luke's Center for Advanced Gynecologic Care 250 Cetronia Road Suite 305 Allentown PA 18104 glazerl@slhn.org On May 6, 2008, at 5:29 PM, Ronald Ainsworth wrote: > Only if you have separately identifiable services - > i.e. ICD9 codes. Then you need to use a 25 modifier, > as others have noted. > > --- Lynn Montgomery <apgar10@thebirthcentermt.com> > wrote: > >> Listers, >> >> I would like opinions regarding a billing question; >> when a patient >> presents for an office visit for an IUD insertion or >> colposcopy for >> example, is one allowed to bill an office visit in >> addition to the >> actual procedure being performed (i.e. 99203 for >> office visit and 58300 >> for IUD insertion). I have gotten different answers >> from various >> coders, including ACOG! >> >> Lynn >> >> Lynn D. Montgomery, M.D. >> >> Obstetrics & Gynecology, Maternal-Fetal Medicine >> >> The Birth Center/Rocky Mountain Women's Health >> >> 1211 S. Reserve St. >> >> Missoula, Montana, 59801 >> >> 406-549-0978 >> >> fax 406-549-0987 >> >> e-mail: apgar10@thebirthcentermt.com >> > Next message: Ronald Anisworth: "Re: OB: Planned Home Birth After Previous Cesarean" Previous message: Henry Gregor: "Re: Billing question" In reply to: Larry Glazerman: "Re: Billing question" Next in thread: Larry Glazerman: "Re: Billing question" Reply: Larry Glazerman: "Re: Billing question"

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