Question about coding

[lookleft]

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I've been given different answers to the following question and wanted to see if anyone could provide more insight.

1.) Can I bill for an emg/ncs and a follow up visit on the same day? If I get a history, exam can I bill for both the emg and a follow up visit?

Thanks

 

[typhoonegator]

Came here looking for an ACLS or ATLS discussion, and found medical coding instead. Was hoping to talk about the utility of bicarbonate pushes. Too bad.

Anyway, can't you just write a 3 page note and bill 60 minutes of critical care time?

I kid, I kid.

 

[TUGM]

can you talk about bicarb pushes anyway?

 

[typhoonegator]

Useful in long codes from my experience, but not a formal part of the ACLS algorithm anymore. From animal models, it may actually worsen tissue acidosis because of the H+ exchange. It really does transiently help maintain perfusion pressure when the epi drip just isn't cutting the mustard, though, at least from my experience. Hasn't been reliably demonstrated to improve survival or ROSC which is why it doesn't appear at the algorithm level, but that shouldn't keep you from trying it in the right situation.

I like using it because it makes me look like an O.G. And of course the code is all about me.

 

[Converted]

I like using it because it makes me look like an O.G. And of course the code is all about me.

O.G. = overpowered ogre?

 

[typhoonegator]

O.G. = overpowered ogre?

Wouldn't that be "O.O." ?

Apologies, lookleft, this has gone as far astray as it possibly could have.

I really hope everyone knows that O.G. is Original Gangsta. Man I'm old.

Or Olive Garden, I suppose.

 

[lookleft]

I love olive garden too, especially their breadsticks and alfredo dip. However, wanted to get a confirmation that I can bill for a follow up and emg/ncs on same day? Thanks fellas, and yes you all are true O.G.'s

 

[bustbones26]

I love olive garden too, especially their breadsticks and alfredo dip. However, wanted to get a confirmation that I can bill for a follow up and emg/ncs on same day? Thanks fellas, and yes you all are true O.G.'s

Here is what I have been told. Theoretically you can so long as a consult was requested. That is the key, the "verbage" on your consult. If the primary physican consults you strictly for EMG, the answer is no.

If they consult you to see the patient to "consider" an EMG, then what I typically do is perform a consult, then ask the patient to return at a later date/time for EMG. Could I just do the consult/EMG in one day? Perhaps, but this is the murky part that I just don't flirt with.

Truth is, depends on your venue. I schedule 60 minutes for new patient, 20 minutes for follow ups. So with a 60 minute block, I have to admit, I'd probably get behind doing both a consult and EMG in that time, so I just do not do it.

Now, if you work for a government institution such as VA or military hospital, go for it, they pay you no matter what.

 

[lookleft]

thanks for the response. I am aware you may do a consult and emg on same visit. However I wanted to see if you can bill for a follow up and emg/ncs on same visit.

For e.g., referral made for a neuropathy evaluation. I see the patient, schedule the patient 2-3 weeks later for emg/ncs. After my emg/ncs I decide to order certain labs. I examine the patient, order labs, etc after the emg/ncs. Can I bill for a follow up as well?

Thanks.

 

[CB1Antagonist]

You can bill the EMG with the followup visit using modifier 25 provided that the followup visit (E&M service) also addressed an issue not connected to the EMG