Posted on 10. Jul, 2009 by in Hot Coding Topics
Vasectomies are commonplace in most urology practices. But choosing the proper codes to report can prove challenging, starting with the pre-vasectomy “consultation” visit most urologists perform. If you’re not billing out each piece of the vasectomy process, you could be costing your practice hundreds over the course of one year. Follow these four steps to ensure you capture all the reimbursement your urologist deserves.
1. Avoid Automatically Assigning Consult Codes for the First Visit
Before a urologist performs a vasectomy, he usually meets with the patient to discuss the procedure and ensure that the patient understands the consequences of the procedure and wishes to undergo this elective sterilization. You’ll report this office visit using the appropriate E/M code, says Kelly Young, a coder with Scottsdale Center for Urology in Scottsdale, Ariz.
The coding challenge comes when you try to determine whether you should be reporting an office visit E/M code or a consultation code.
Depending on your urologist’s documentation, you’ll choose from the consultation codes (99241-99245, Office consultation for a new or established patient …), a new patient (99201-99205, Office or other outpatient visit for the evaluation and management of a new patient …), or established patient (99211-99215, Office or other outpatient visit for the evaluation and management of an established patient …) codes.
See the dollar signs: If you skip reporting the pre-vasectomy office visit, you’re forfeiting money. For example, if your urologist performs a level-three new patient visit (99203), you’ll earn $91.97 (the unadjusted fee for 99203, 2.55 RVUs, times the 2009 conversion rate of $36.0666) in addition to the procedure code, and if your urologist performs a level-three consultation, you’ll earn $125.15 (the unadjusted fee for 99203, 3.47 RVUs, times the 2009...
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