1. M

    Return to work exam

    I'm confused about how to code return to work visits. We get patients who have been off work due to illness and they come in for a return to work exam and form to be filled out. Should this be coded as a preventive exam if the illness is resolved and no other problems are found?
  2. G

    AWV vs Preventive vs E&M

    We are having a difference of opinion between coders and billers, Coder coded as 99397.GY No HPI Missing updated written screening schedule 5-10yrs Visit qualified as preventive and preventive 99397 is not covered by Medicare Biller wants code changed to 99214 as provider refilled RX looked at...
  3. M

    Dx code for prescribing "just in case"

    Hey there, So I have a provider who, in two separate encounters, has prescribed a patient medication in case they become ill. The first was for a patient taking a hunting trip, who was prescribed an antibiotic if he were to present with respiratory issues (no previous history of, currently...
  4. M

    Depression Screening

    I was wondering if anyone knows if you can bill the G0444 Depression Screening if the patient already has an existing diagnosis of depression? I have been researching this, however, I cannot find anything that says you cannot bill the G0444 for this situation. Thank you in advance!
  5. J

    Z00.00 for every follow up

    Hi, I work at a clinic and there are a couple of providers that, during a follow-up appointment, will review that vaccines, basic labs and screenings are up to date, and document it similar to this: Adult health examination - Basic labs: 11/6/17 Colonoscopy: 2/2014, 2 polyps and mild...
  6. E

    New office visit + preventive

    A chapter member posted this question, and I haven't looked up guidelines yet: Hello, Office debate: New pt has an office visit and physical at same appt. Is this coded w one new and one est code or two new or codes? Thanks
  7. kfrycpc

    AWV and IPPE

    This question is two fold and I need fresh opinions: We have a long standing issue in our office. When a physician bills a preventive visit for a Medicare pt, it has to be either an IPPE or AWV. 1. When the Dr bills a regular preventive and bills a 99396....we cannot convert the code to...
  8. J

    AWV and Consult on same day.

    Hi, Can an AWV G0438/G0439 (either initial or subsuquent) be reported with an outpatient consultation (99241-99245) on the same day? I checked the 10/1/16 CCI edits and these coding combinations are not present. [I am compiling documentation of preventative services for physicians to reference...
  9. L

    Wiki Excludes 1 denials - Preventive w/ Contraception Procedure on same day

    Hello fellow coders! I am the sole coder at a Family Planning/Title X – State funded clinic. With that funding source we must adhere to guidelines set forth by the State in regards to women’s contraceptive measures. This means that if a woman presents for an annual exam and indicates that she...
  10. L

    Well Visit/ Well Woman

    Hello! I am wondering, I know the patient can have a preventive visit with her normal pcp and then a well woman with her GYN, but what if a patient comes to her pcp for a well exam (preventive visit) and then comes back few days later to have a routine pap smear; can we bill the pap as...
  11. KScoderTN

    DX for labs ordered during preventive visit

    Office discussion: Patient is schedule for their annual well/preventive visit. No abnormal findings. Doctor simply puts Z00.00 on the order for the lab. Do you query the physician to have them specify diagnosis/ICD -10 since Z00.00 is not a covered diagnosis for the specific labs that are...
  12. A

    Physician billing for test ordering

    Can a physician bill for ordering certain tests? For example breast cancer screening, colon cancer screening. The tests will not be done in the office but can we still bill for the actual ordering of these tests? If so, what CPT codes should be used?
  13. N

    Preventive and sick visit question

    Hello everyone, Is my understanding that if a patient reason for the visit is for an annual assesment/exam and patient complaint of other problems I will bill the preventive code with dx v70.0 and the office code with the problems, and mod 25. Now If the Dr. does not assessed v70.0 on the...