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Nancy Posted Wed 26th of May, 2010 18:34:24 PM

I am sure this has been asked before but I am unable to find. So I am going to ask again. I have a patient who was seen in our Ortho Dept on 12/09/09 for a new patient consult for bilateral knee problems. Decision was made to do the RT knee surgery first which was done on 02/05/10. Patient has now came in for a pre-op visit to schedule and do the LT knee. Can this E/M visit be billed? Insurance is denying as inclusive to dos 02/05/10. Please help. Thanks

SuperCoder Answered Thu 27th of May, 2010 06:27:24 AM

On the previsou visit, the decision was taken for the right knee surgery about two months prior to the surgery. If the patient has come now, it means this visit is not even falling within the global period of the first surgery. Anyway, all the knee surgery codes are basically unilateral , which means the surgery to the LT knee is not related to the previous surgery done on the right knee and hence deserves a separate E/M.

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