• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki annual wellness visit with pre-op for cataracts

Create Wiki
L

laberube

Guest
Messages
2
Best answers
0
One of my physicians wants to bill a pre-op cataract visit along with an Annual Wellness Visit. I wouldn' think we could, Does anyone have correct information on this?
 
You can bill an additional E&M visit with the annual wellness visit, as long as the visit is medically necessary, the documentation supports separately identifiable work, and that the pre-op visit doesn't bump up against any global days. Just make sure that the patient is aware that you're billing both; there will be deductible and co-insurance responsiblity for the patient with regard to the E&M visit, since they might be expecting the "free" visit only.
 
annual wellness visit with pre-op clearance for cataracts

Even though its actually a pre-op consult Medicare will allow both?We are so used to not billing a pre-op consult with a preventive and we thought this would follow the same guidelines.
Thank you
 
I don't think I told you to bill a consult, I said that you can bill an additional E&M if appropriate. It's up to you to determine if the guidelines are met with the content of your providers' documentation.

Per Noridian:

During an AWV or IPPE, several medical conditions are brought up. Are we able to bill the AWV in addition to an E&M?
[FONT=Arial,Arial][FONT=Arial,Arial]A37. Both services can be billed if the E&M is significantly and separately identifiable from the AWV or IPPE. The appropriate level of E&M should be reported and documented and 25 modifier appended. [/FONT]
[/FONT]
 
Last edited:
But in this case since this is a pre op visit, we have to bill 99024 with dx v72.83 preop visit and 366.9 cataract uns.But for the AWV or whatever the case is ,bill the appropriate G code with dx V70.0.
 
You must log in or register to reply here.
Top