Forum - Questions & Answers

Mar 31st, 2011 - BETH1031

Office visit/procedure billing question

I have a patient that came in for toe pain. He decided to to an arthrocentesis. Can I bill for the Office Visit AND the Arthrocentesis, or just the arthrocentesis? I was told you can only bill for the procedure the doctor decides to do for a dx and not the office visit also if it is the same diagnosis. Is this true, or can I bill for both?

Mar 31st, 2011 - agent00711   151 

re: OFFICE VISIT/PROCEDURE BILLING QUESTION

It sounds as if the arthrocentesis was not preplanned. In this instance, I would bill for both the E/M service as well as the procedure appending modifier -25 to the E/M. Also, it is not necessary to have two different diagnosis. If you would like additional info regard the -25 with procedures, please let me know your email address. Have a great day!



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