Wiki probably an easy Preventive visit question?

ollielooya

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Anyone around here on the weekend that can answer this question, or give some thoughts on how to deal with this scenario?

A patient comes in to see the Family Practice Physician's Assistant for her check-up wellness visit. He charges 99395. This pt has commercial ins. The next week the same patient comes into see her OB/GYN for her well woman visit and he does a pap & pelvic. He also charges 99395. Might this work? Looking for any input....or questions....I'm stalled.
 
Anyone around here on the weekend that can answer this question, or give some thoughts on how to deal with this scenario?

A patient comes in to see the Family Practice Physician's Assistant for her check-up wellness visit. He charges 99395. This pt has commercial ins. The next week the same patient comes into see her OB/GYN for her well woman visit and he does a pap & pelvic. He also charges 99395. Might this work? Looking for any input....or questions....I'm stalled.

I think both visits are coded correctly, but chances are her insurance is only going to pay for 1 visit at 99395. It's possible that the OB/GYN could just charge an E/M for their visit plus the pap and pelvic, but if they truly did a preventative exam, then 99395 is correct and the patient is most likely going to be billed for the extra visit. Usually women see the ob/gyn for their annual preventative exam, and maybe the family practice practioner for a chronic condition such as diabetes.
 
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