Medicare Compliance & Reimbursement
Take This 'No Man's Land' Coding Advice
Question: A mother brought her daughter for a well child check-up, although she didn’t have an appointment. The nurse worked them into the schedule and checked the child’s vitals. When the physician came into the room, the mother said they couldn’t stay any longer and she left without anyone completing the check-up. Can we code anything for this visit?
Answer: Just because the nurse saw the patient doesn’t mean you can file a claim; if the pediatrician did not have a face-to-face encounter with the patient, you cannot bill for this scenario.
Different situation: If the patient leaves after the pediatrician has seen her for part of the visit, you can report the appropriate preventive medicine visit code and append modifier 52 (Reduced services). Include documentation supporting the service the physician provided.
Medicare Compliance & Reimbursement
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Take This 'No Man's Land' Coding Advice
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