Wiki 1 week well child exam

[cynthiarjakyma]

I work for Pediatricians. The physicians must see all newborns within 1 week of birth. They then have to be seen for a 2 week well exam. How can we code the 1 week office visit as a well child exam (V20.2) and still be paid correctly for the 2 week well child exam (V20.2)? We are concerned that this will max out the patient's well child exams too quickly and their future immuizations may not be covered.

Any suggestions on how to code the 1 week exam and then a 2 week exam the following week?

Thank you very much

 

[hewitt]

To suggest a resource, so you are not stuck looking for answers for long periods of time is The American Academy of Pediatrics http://www.aap.org/en-us/Pages/Default.aspx If your physicians are memebers, you can use their ID to call them for coding help. They have other terrific resources as well.

 

[DawnPruitt]

I use V20.31 for babies under 8 days of age for their 1 wk check and V20.32 for babies between 8 and 28 days for their 2 wk check with the correct preventative cpt code.

 

[KERRIEA]

I agree with Dawn's post. We do the same and have no trouble getting reimbursed for all of the visits.

 

[StephSH]

We use v20.31 / 99391 for the first visit and then based on age, we use either v20.31 or v20.32 with a 99213 for the additional visits between then and the 1 month well visit. This gets paid by everyone but Medical Mutual, who we have to code with the 99391 no matter how many times the patient comes in that first month.

We dont normally run into Well Visit Maxes with that coding combination and some of our babies come in three times the first month just for weight checks.

 

[suemt]

If the second visit is not a sick visit, what is the basis for coding 99213 instead of 99391? Also, my pediatric billers are telling me that using the Vcodes with E/M visits results in denials.

We use v20.31 / 99391 for the first visit and then based on age, we use either v20.31 or v20.32 with a 99213 for the additional visits between then and the 1 month well visit. This gets paid by everyone but Medical Mutual, who we have to code with the 99391 no matter how many times the patient comes in that first month.

We dont normally run into Well Visit Maxes with that coding combination and some of our babies come in three times the first month just for weight checks.