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Posted By Lynn Radecky on 01-22-2018, 15:48:12 in Ob-Gyn
When the doctor does a sonohysterogram in the office we book a 30 minute appointment. He does an exam, performs the procedure and then sees the patient in his office to discuss the results. We bill 76831, 58340 and either a 99213 or 99214 with a 25 modifier. Some insurance companies do not want to pay for the separate office visit stating it is included with the procedure. He dictates in his notes how long he counsels the patient in the office, any advice on whether it is appropriate to bill for an office visit in addition to the procedure? Thank You!
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Posted By Melanie Witt on 01-22-2018, 17:24:00
All ultrasound procedures include work by the physician in communicating the results to the patient or the ordering physician, and all surgical procedure codes include at a minimum a quick H&P prior to doing the procedure, explaining the procedure, plus review of records and then explaining the results to the patient or the patient's family. You should only be billing if the, E/M service is absolutely separate and significant above and beyond the expectations for the work included in both 58340 and 76831.
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