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Linda
Brandwin, R.N.
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Linda
Brandwin
is a registered nurse and a medical billing
and claims specialist. For the past 10 years
she has worked directly with insurance companies
to give advice and guidance to the health care
consumer.
Readers may send email
or write Linda Brandwin at 5500 Single Oak Hill
Ct., Woodbridge, VA 22192.
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Nasal
sinus endoscopys are considered surgery
Sept 17, 2004
Q:
I
went to my ENT doctor for some sinus problems. In the
office I had a nasal sinus endoscopy. The doctor said
I needed surgery but I refused and left. My insurance
paid the office bill. But I was surprised to see that
I was charged not only for an office visit but also
over $300 for surgery. I called my doctor's office and
told them I elected not to have surgery. The nurse explained
that the nasal sinus endoscopy is considered surgery.
I do not understand this.
A:
Every
single thing done to you during an office visit is broken
down into individual components called procedures. Even
though the sinus endoscopy does not seem like what we
normally think of as surgery, it is considered as a
surgical procedure. It is just a label to categorize
the endoscopy for insurance and billing purposes.
A
common example of a surgical procedure that does not
seem at all like "surgery" is when you get
your blood drawn. This routine venipuncture is listed
under surgical procedures. A surgical procedure is usually
considered as something invasive in nature.
There
are six categories that all procedures fall under. They
are evaluation and management procedures which are usually
your visits with your health care provider. The other
categories are anesthesiology, surgery, radiology, pathology
and laboratory, and medicine.
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