Forum - Questions & Answers

Oct 18th, 2010 - paulapreston 8 

E&M visit same day as Bone Marrow Biopsy/Aspiration

Is it appropriate to bill an E&M on same day as bone marrow bx?
Physician goes over labs & explains procedure, but no separate problem is
addressed. Is there a CMS directive? Thanks, Paula

Oct 18th, 2010 -

CMS is not involved in this

the general guideline is that if an appt is made to perform a procedure then you do not bill an E&M. The consent process is included in the procedure's RVU. If this patient has already been seen by the doctor, no E&M. If the patient was referred by a primary care doc for a hematologic abnormality and the doctor obtains a full History, performs physical, does medical decision making and decides to do bone marrow on the same day, then an E&M is ok.

Oct 21st, 2010 - Codapedia Editor 1,399 

I'm going to agree with signature doc

If the purpose of the visit was the bone marrow aspiration, bill only for the procedure.

If the patient presents with an unknown problem, the MD does an assessment and says, "Hey, let's do a bone marrow" bill for both.

But if the patient has been assessed, a bone marrow biopsy/aspiration planned, bill only for the procedure.



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