Patricia Posted Tue 13th of December, 2016 14:54:30 PM
I would like to know how you are billing for the patients who come to you for a clearance for surgery. Our physicians are charging office visits with the diagnosis for the surgery and this is causing the patients to be upset with the co pays.. Please let me know if this is correct.
SuperCoder Answered Wed 14th of December, 2016 08:42:27 AM
When patient comes for surgery clearance, there should be office visit charged. As per the general coding guidelines when provider decides to perform surgery the day of the E/M service or the day before, then append modifier 57 to an E/M service, therefore E&M service that resulted in the initial decision to perform the surgery is identified by 57 modifier, otherwise bill only office visit. If it is pre-op clearance, you can code all pre - op clearances as consultation codes, in this case just be sure you have a request form from the Dr. or Hospital. Between, co-pay does not affect the service performed by the physician, it depends upon the policy opted by the patient.