Documentation Please

Ladies, I need documentation to back up the talk.

Once an E&M is made, you cannot do the same problem E&M unless something else is new with this problem, i.e., twisting of the knee when a patient has arthritis.

We have known patients that have arthritis - with numerous cortizone injections - that coders will consistently bill an E&M for. Unless there is something other than arthritis being seen for, I do not because they have been evaluated several times for arthritis.

I have a doc that wants to bill an E&M every time a patient presents for viscosupplementation - well, some say you can bill for an E&M for the first injection and I still say not if you know if the patient has arthritis.

This is what is wrong with the system - that is why BCBS of Nebraska is now asking for documentation for every 25 and 59 procedure.

Any thoughts or suggestions but please I would love to have documentation the most of all.


  • edited May 2017
    If it is a scheduled injection, we do not charge an office visit, if that is essentially all that is happening. In the words of my coding boss, "There's a little bit of e/m in every procedure."

    Jill Smithers, CPC, CEMC
    Physician Coder III
    Ortho, WMC IPG
    Appalachian Regional Healthcare System
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