Consultation codes are not used for Medicare patients now. Therefore a patient coming to the office for the first time has to be billed using a New Patient Visit code that ranges from 99201-99205, provided no one else in your office in the same specialty has given face-to-face service to the patient in the past three years. Consultation codes are used for private insurance companies. You can get knowledge about Natural Medicine Seattle via various online website.
Medicare demands a clearly documented History and Physical Exam or H&P before any procedure carried out at an Ambulatory Surgery Centre (ASC). This H&P procedure is treated as part of the procedure provided and cannot be billed separately.
A gastroenterologist carrying out H&P for a patient presenting with symptoms at his office, and then deciding that an immediate procedure is required can bill for both the procedure and visit on the same day. However, the E/M service during which the physician made the decision to perform the procedure should be documented. The 25 modifier has to be added along with the visit code.
A reduced service is signified by the modifier 52. An instance is when the physician plans to do an EGD, but fails to advance the scope to the duodenum probably due to an obstruction. Here he cannot bill for an oesophagoscopy, but can report an EGD with the 52 modifier.
Medicare distinguishes between average risk patients and high risk patients when it comes to screening colonoscopy. The time restrictions differ in both cases, with it limited to once in every 10 years for average risk patients and once every 24 months for high risk patients.