Saw patient, canceled procedure but did brief assessment

[emd123]

A patient comes in for a scheduled procedure. Vitals are checked. A discussion is had, and you find out he/she's being treated for a UTI. You decide to cancel the procedure. You've done a brief assessment, spent 5-10 with that patient, discussing etc. What do you do?

No charge?

Bill insignificant Level 1?

Bill Level 2, since you spent up to 15 min by doing vitals, discussion, charting why the procedure was canceled, etc?

It doesn't happen too often and is not a big deal, but was just wondering what the concensus is on this, since physician time is spent, often vitals are checked, chart and their current treatment/medication is reviewed.

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[mdvol]

longstanding patient, do you like them, do their family and friends also see you or partners?

 

[SSdoc33]

absolutely bill.

personally, id bill a level 4 f/u because a medical decision was made not to do the procedure because of risk or infection.

 

[Ducttape]

dont not bill - you could be charged with fraud.

on the other hand, if nurse tells you about infection and antibiotics, and you casually swing by and, outside the door, yell loudly, "i sure as hell wouldnt do an injection on that patient, and they shouldnt have their copay collected"......

 

[emd123]

dont not bill - you could be charged with fraud.

on the other hand, if nurse tells you about infection and antibiotics, and you casually swing by and, outside the door, yell loudly, "i sure as hell wouldnt do an injection on that patient, and they shouldnt have their copay collected"......

No, I'm not talking about a phone cancelation or something like that where the patient is never there or you never walk in the room, but where you do actually assess the patient, spend time discussing the issue, pro's con's, check vitals, etc. There's a face to face encounter, assessment, etc.


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[hyperalgesia]

Like mdvol, for me it would depend on deductible, referral, and other factors. If this is a potentially high quality future patient from a good referral source, who has not met her deductible and will be basically paying cash, I wouldn't charge. OTOH, I'd probably charge a 2. None of this because I'm trying to be nice, you are totally owed the E/M. But just because you can probably get more E/M later...

 

[DOctorJay]

What do you guys do/suggest when your patient shows up for medial branch blocks and says they have no pain or very low level of pain, say <5/10. We reschedule but are you going to bill for that?

I tell all these people to call and cancel if they aren't having significant pain and ask them not to take any pain meds the morning of the procedure and throughout the rest of the day but people just don't listen.

 

[lobelsteve]

What do you guys do/suggest when your patient shows up for medial branch blocks and says they have no pain or very low level of pain, say <5/10. We reschedule but are you going to bill for that?

I tell all these people to call and cancel if they aren't having significant pain and ask them not to take any pain meds the morning of the procedure and throughout the rest of the day but people just don't listen.

If they have an activity or position that can readily reproduce the pain (facet loading, golf, dishes, shopping) then I do the block if they will try and provoke their pain. The definition of functional improvement is met.

 

[Tenesma]

if i interact with the patient at all and cancel a procedure - i will bill a level 1...
if i had to spend 15 min w/ patient then that is automatically a level 2-3 depending on what was discussed.

 

[pmrrulez]

I will bill a level 3 if we have a discussion and I perform brief physical exam. If it's a quick," I am on antibiotics and I can't do the procedure", I don't bill for it.