Rank: New Member
Joined: 2/16/2015(UTC)
Posts: 2
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I think I recall Janice telling me I can't charge for an exam the same day I'm doing procedures. I would like to bill out for orthopedic jaw casts, myofunctional analysis, and radiographs since that is all part of me making my diagnosis and recommendation for treatment. I usually do my exam and take all records at the first visit, then bring the patient back to give diagnosis and treatment options. How should I do this if I'm filing medical to make sure I get paid for my services?
Thanks,
Tesha
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Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,732
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Hi MWD2015!
Great questions. You can bill out E&M (evaluation & management) codes for your office visits/exams in many cases. However, as Janice mentioned, some insurers will consider the office visit included in the service you are doing (for example, on the delivery day for an oral appliance for sleep apnea, most insurers considered the E&M (office visit) included in the code for the appliance - E0486).
However, if the E&M code you are billing is a separately distinguishable service or procedure, you can use the modifier -25 to show "significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service)"
Hope this helps, please feel free to contact us with any further questions!
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