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Office visits and using Modifier 57
Posted By TESSA Vaughan on 02-10-2021, 12:16:37 in Ob-Gyn
1-19-21 - pt comes in for a yearly exam / billed cpt code 99385 with dx codes Z01419, F3281, N921, N944 )
02/02/21 pt brought back for colposcopy w/biopsy / billed cpt code 99212/25 with dx code N944, R87810, N921 and 57454 w/dx code R87810
02/09/21 - pt is brought back again for pelvic ultrasound / billed cpt codes 99213/57 & 76830 w/dx codes N920, N944, R102 / Diagnostic Laparoscopy / D&C Hysteroscopy is scheduled for 3/03/21.
My 1st question can an ov be charged on all the above?
2nd question is regarding modifier 57. I was under the assumption that modifier 57 was used when the decision was made to have sx done either that day or the next day
Thank you in advance for your help!!! :)
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Posted By Melanie Witt on 02-10-2021, 13:51:30
No, you may not bill an office visit with the 2/02 or 2/09 visit as the patient was scheduled for procedures. Only if an unrelated problem was addressed could you do so. As to the modifier -57 - it is only used when a MAJOR (90 procedure) is being performed and the E/M visit was the to determine the procedure was to be done on that day or the next day. A modifier -57 would never be used with an E/M and a ultrasound procedure in any case.
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