tci Outpatient Facility Coding Alert - 2013 Issue 5

Reader Question: Watch for Different Payer Policies on Billing Drugs With Anesthesia Service

Question: Our GI group owns its own endoscopic suite where colonoscopies are performed in this suite we bill POS as Office. Sometimes the patient is given Zofran through the IV used for the anesthesia. Our physicians do not bill for the anesthesia. We have an anesthesiology group that comes in and bills for the entire anesthesia done at our endoscopy suite. Since we don’t bill for this would it then be appropriate to bill for the 96374 with a 59 modifier and the J code for the Zofran? Hawaii Subscriber Answer:  As a norm, you should not...

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