Medical Billing Forum
General Category => General Questions => : JanK March 27, 2009, 07:18:59 PM
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I'm wondering how to charge for the following - an established patient came into our office after having a subcutaneous mastectomy done in another state. She was having problems with her drainage tubes. Our doctor was able to remedy the problem after considerable effort and normal drainage was restored. How do I bill for this service? ???
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Since your provider did not perform the surgery, and the patient was not able to return to the surgeon, I would bill it as a regular office visit (or whatever cpt code describes the service). I believe it should be coded as the surgery cpt with a modifier indicating post op care, but I would bet the surgeon did not bill indicating that he/she did not provide post op care, so it would probably be denied.
Michele
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Thx Michele - that's kinda what I was thinking.
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YES.. BUT.. if the patient moved, or re-located OR they were on vacation where they could not see the surgeon, the claim can be appealed, in many cases also if the move is permanent you can setup to transfer post-op visits. In any case, you can appeal based on the circumstances.
I had my C-Section in one state but moved 2 hours away from my OBGYN and he just transferred my records to another doctor who did my follow-up.
Linda Walker
PMRNC
www.billerswebsite.com