A 31-year-old woman (gravida 2, para 1) presents to your office at 6 weeks’ gestation. She is complaining of vaginal bleeding and pelvic pain. You perform an evaluation and management (E&M) service and ultrasonography and diagnose an ectopic pregnancy. After discussing the options with her, you perform a laparoscopic salpingectomy on her later that afternoon.
How would you code this?
A.Code only for the laparoscopic salpingectomy since the E&M service and ultrasonography are within the global period and therefore part of the global surgical package.
B.Code for the laparoscopic salpingectomy and the ultrasonography but not the E&M service since the E&M service is within 24 hours of the surgery and therefore part of the global surgical package.
C.Code for the E&M service, the ultrasonography, and the laparoscopic salpingectomy separately. I may have to appeal the denial of the E&M service if the third party payer considers it part of the global surgical package.
D.Code for the E&M service, the ultrasonography, and the laparoscopic salpingectomy separately. I would place the -57 modifier on the E&M service to signify that this was the E&M service that resulted in the decision for surgery. I would expect to be reimbursed for all 3 procedures since the decision for surgery is never part of the global surgical package.
E.Wait for the operative note to arrive in my office and my staff would code for the procedure.