GYN/Oncology Post-op visit

Post here your questions regarding auditing ,coding, documentation, and compliance. Also, join in on the conversation- help your fellow auditors and compliance professionals in the industry.

Moderators: Shannon DeConda, NAMAS Moderator

Post Reply
Shoshana
Posts: 73
Joined: Fri Jun 23, 2017 1:41 pm
Location: Multi-specialty Clinic

Thu Dec 07, 2017 9:47 am

I have had a question from my GYN/oncologist regarding post-op visits. He states he sees the patient for the surgery follow-up, assesses the site, etc. and bills 99024. Then the visit turns into a counseling and coordination of care with discussion about chemo treatment, side-effects, schedule, etc. He wants to bill this with a time code and attach a 24 modifier. Do any of you have any experience with doing that? I get that it is really a separate visit from the surgical follow-up. I feel he can do this. Can anyone guide me on if I am correct in my thinking? The note reads as two separate visits. He understands the time element only covers the counseling part of the visit and that his discussion needs to support the time he is spending.
"In any moment or decision, the best thing you can do is the right thing." - T.Roosevelt
Shoshana, BA, CPC, CPMA, CPCO, RRT
User avatar
admin
Site Admin
Posts: 431
Joined: Mon Apr 09, 2012 1:54 pm

Wed Dec 13, 2017 11:19 am

The documentation should show the extent of counseling regarding the chemotherapy. The only thing that stands out to me in the original question as perhaps not allowing a separate visit is the brief mention of a chemotherapy schedule. If this visit is the first that puts that schedule in place, then you have a solid argument for a -24 modifier service. If this is to discuss a schedule that is already in place, I would find it hard to believe that the bulk of this conversation was necessary. Based on the wording of the question, the patient’s planned treatment course was surgery, followed by chemo, and now the patient and physician are planning Phase 2. In that case, bill the E/M with a -24 modifier.

Your question has been answered by Paul Spencer, CPC, COC
Post Reply