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Performing a diagnostic test on a patient who has not established care

David Posted Fri 21st of October, 2016 10:07:32 AM
My manager has the following question and I am hoping someone might be able to answer this: We are a Urology clinic who has been asked to performed the ARM (diagnostic testing which is called anorectal manometry for fecal incontinence) by another clinic. So they want to send their patients here only for us to perform this test. These patients are not our patients so have no established care with us. My managers concern is that we are not considered a diagnostic testing facility, so how can we can we truly perform these tests on patients who have no established care with us and can we actually bill for these? We do the technical and professional component of these and those results are provided to their primary doctor who sent them here to be tested. I appreciate your feedback. Myself and our other Coder do not see any issues with this and believe we should be able to bill, but would like to check into it a little more before getting back to management. Thank you Kelly COC
SuperCoder Answered Mon 24th of October, 2016 03:51:45 AM

Hi,

As per the above documentation, you can bill for ARM (diagnostic testing, anorectal manometry for fecal incontinence).

New and Established patient concept is valid only in evaluation and management services; anorectal manometry is a procedure, so, it is appropriate to bill for the procedure performed. Thank you.

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