H&P's

How are H&P's to be coded, as E/M's? What if its the same surgeon that is going to perform the surgery? Are these coded or included in the procedure?


TIA

Richard

it depends

Has the surgeon seen the patient in the past for the issue and now needs to do the H&P for the hospital (it is bundled in the surgery) or is the patient seen for the first time in the ER or hospital for an acute problem and the decision to go to the OR is made at that time (not bundled and can be billed as a consultation [until 1-1-10 then with initial visit code] with a modifier to indicate decision to take to OR)

H&P's

The patient was seen in the ER one day after a fracture. The Orthopedic surgeon performed a closed reduction. One week later, the patient comes into the clinic for an examination for an open reduction that will be performed the following day; this was performed by the original Orthopedic surgeon who did the closed reduction. He is charging for a level, which I know is incorrect because its within the global of the original closed reduction.

I'll bump this to the Editor

I am guessing no charge for the H&P- the patient was established and it was not a new problem.

Was the second procedure for the same fracture?

If the second procedure is UNRELATED to the first, the E/M is payable with a -24 modifier.

Can you explain this out for me like this:

2-5-09 patient fell, E/M charged, closed reduction, diagnosis code XXX

2-10-09 etc.

Is the physician operating on the same fracture, with two treatments?