Annual Exams

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4
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Howard, SD
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Problem #1: When a patient comes in for a annual wellness examination to their OB/GYN and they talk about all their issues like postmenopausal status and fibrocystic breast disease. They do a full blown examination and document it all. How would you go about coding this? Would you just use a V70.0 and the additional dx's or v72.31 and the additional dx's and would you use a clinic e/m or a wellness e/m?

Problem #2: I would also like to know if you can do a full blown annual exam and still use the v72.31 diagnosis or would it be more appropriate to use v70.0?

Please help me with this as this is a huge problem in our clinic. :eek:
 

dmaec

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Hibbing, Minnesota
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for Problem #1: I would use the V70.0 and any additional codes needed, I would use the V76.2 if they did a routine pap. I would use the age appropriate preventive E/M code. (of course, documentation would have to support the services provided)

for Problem #2:again, I'd use V70.0 -

I guess we rarely use the V72.31 - we typically use that code for SAGE patients.
 
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4
Location
Howard, SD
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So you would still use a V70.0 and a preventative E/M........That is what I usually always use. The problem with our clinic is that they like things to get paid from insurance and we have one insurance that will not pay for annual exams coded like this. They would rather have a V72.31 and a clinic E/M. Well I feel really uneasy changing codes just so it will get paid. What would you do in this case?

Also if they are coming in for a annual and plus renewing a contraceptive how would you guys code this then.

Thank You,
Jennie
 

dmaec

True Blue
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1,133
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Hibbing, Minnesota
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I guess I'd appeal their denial of the services then. (if it's coded correctly). as for renewing their birth control, I don't code/bill separately for it, although of course we code out the Jcode meds or procedure (whatever the case might be) with appropriate modifiers if needed.
 
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