Billing E/M with Non-Covered services

[pod squad]

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Having trouble finding an answer to this online. Let's say you see a patient for a cash-pay non covered service such as shockwave. If you also treat them for a covered problem such as a plantar wart on the same visit, can you bill an E&M code for that? Or is that considered 'double billing'.

 

[HardRoadPaved]

Absolutely acceptable even if it was 2 different issues both covered by insurance. For Medicare just make sure you have an ABN and afix proper modifier indicating that they paid out of pocket

 

[heybrother]

The above sounds kosher. Someone told me a story once of patients who routinely receive uncovered callus trimming being billed for a 99212 everytime they are seen for the uncovered trimming because "they make the determination to trim" everytime.

 

[Feli]

Yes, of course... still are eval their progress/options (typically).

If they have a copay, sure won't make you any friends if you are blasting them on laser cash fee and also billing e&m tinea or something tho.