Coding Pt II
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When billing based on “time”, the total amount of time the patient spends in the office is the deciding factor, regardless of how much time the provider actually spent directly counseling the patient.
A notoriously “high maintenance” established patient came in today with another list of concerns. A total of 35 minutes passed from the time she was called back until she left. Of those 35 minutes, your supervising physician was actually in the room and counseling her for 20 minutes. If this visit were to be billed based on “time”, which E/M code would be appropriate?
Charging separately for procedures/services which should have been billed under a single code is called __________.
Two-digit codes which are added to E/M or CPT codes in order to provide “clarification” to the insurance company are called __________.
The most common modifier we use in dermatology is _______.
The time period after a procedure in which all routine and necessary services associated with that procedure are bundled (included) with the original reimbursement for that procedure is known as the _________ period.
Your supervising physician shaves off a mole that has been bothering the patient. She asks you to document and code it as a “shave removal”. She also asks you to be sure and send the specimen off to the lab for evaluation. Because the specimen is being sent to the lab, a biopsy code (11100) should be billed in addition to the shave removal code.
As she describes today’s treatment plan to the patient, your supervising physician says the following:
“I’d like to shave off a sample of the lesion and send it off to the lab for evaluation. If the lab confirms my suspicion of skin cancer, then we’re going to have to plan on excising it. We’ll call you when we get the results in.”
From a billing standpoint, how is your supervising physician most likely going to code today’s procedure?