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coding question about cath UAs

I think I must be doing something wrong- our new billing person brought to my
attention that when I do a cath UA here in the office the insurers will pay
for either that or the visit but not for both. This is something I was not
aware of.
I use the code 51701 for a cath UA in addition to my visit code. Now, last
Friday I did a full sepsis workup on a 4 week old febrile infant and admitted
the child. Though I saw the child here in the office and then admitted him
and saw him that evening again I did not charge for the office visit but did
charge for the LP, the cath UA and the blood draw. I wonder if all these
procedures are going to be lumped into the H and P?
How do you bill for these sort of common scenarios?
Regards-
Kim Burlingham, MD
Winnsboro, TX

coding question about cath UAs

Message from Jill Stoller hidden@email-address

Kim -to get paid for both the e/m code and the procedures put a -25 modifier on the e/m code and the -59 modifier on the procedure codes. I have also found it helpful if I use a separate ICD-9 code for the e/m and the cath code. You ABSOLUTELY should be getting paid for both!

Jill Stoller, MD
New Jersey

On Tuesday, August 28, 2007, at 06:57AM, "Dogwood Ridge" wrote:
>I think I must be doing something wrong- our new billing person brought to my
>attention that when I do a cath UA here in the office the insurers will pay
>for either that or the visit but not for both. This is something I was not
>aware of.
>I use the code 51701 for a cath UA in addition to my visit code. Now, last
>Friday I did a full sepsis workup on a 4 week old febrile infant and admitted
>the child. Though I saw the child here in the office and then admitted him
>and saw him that evening again I did not charge for the office visit but did
>charge for the LP, the cath UA and the blood draw. I wonder if all these
>procedures are going to be lumped into the H and P?
>How do you bill for these sort of common scenarios?
>Regards-
>Kim Burlingham, MD
>Winnsboro, TX
>

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