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PVR ordered by Primary Care, patient is not an established patient

David Posted Wed 19th of October, 2016 15:46:11 PM
I am hoping you have some idea on this situation. Sometimes we get a call from a patients primary care provider asking to send their patient over to us to performed a PVR (post-voided residual - bladder scan). The patient is not an established patient with our providers, and comes in and the nurse performs this services under the direct supervision of one of our providers. Are we able to bill for this service (51798)? Management is thinking because the patient is not an established patient, we are unable to bill for this service. I appreciate your feedback. Thank you
SuperCoder Answered Thu 20th of October, 2016 07:52:04 AM

Hi,

As per the above documentation, you can bill CPT code 51798 for Measurement of post-voiding residual urine.

New and Established patient concept is valid only in evaluation and management services; 51798 is a procedure code, so, it is appropriate to bill for the procedure performed.

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