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Primary Care Coding Alert

Reader Question:

Coding Diagnostic Tests and Office Visit

Published on Mon Nov 01, 1999

Question: Can you bill for diagnostic tests conducted at the same time as an office visit or does the coding for the visit bundle the tests?

Anonymous KY Subscriber

Answer: Many family practitioners believe that they can only code for the office visit. But yes, you can bill for diagnostic tests, according to Kent Moore, manager of reimbursement issues for the American Academy of Family Physicians (AAFP).

He points to the following from CPT 99, which supports the separate codes for the diagnostic procedures: The actual performance and/or interpretation of diagnostic tests/studies during a patient encounter are not included in the levels of E/M services. Physician performance of diagnostic tests/studies for which specific CPT codes are available may be reported separately, in addition to the appropriate diagnostic code.
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