tci General Surgery Coding Alert - 2001 Issue 7

Reader Question: Decision for Surgery Payable Separately

Question: One of my physicians attended a seminar in which he was told if he sees a patient in the emergency department (ED), and then performs a procedure (for example, an appendectomy), the E/M is part of the procedures global package and shouldnt be billed. I disagree: He had to do an examination, a history and medical decision-making to decide to perform the procedure. I believe he should bill an E/M with modifier -57, as well as the procedure. Who is correct? Pennsylvania Subscriber Answer: You are, says Arlene Morrow, CPC, CMM, a general surgery coding and reimbursement specialist...

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