Wiki Billing for follow up visit after fall

[kcouncil]

Hi Everyone,

Does anyone have any suggestions on the appropriate primary diagnosis code you would use to bill a visit where the patient was seen for follow up after a fall. I work for a medical practice within a long term care facility and after a fall it is suggested that you see a MD/NP for a follow up after a fall even if there is no injury. Insurance company does not like when codes that fall under the W01 (fall on same level from slipping,tripping and stumbling) is used.

Thank you all for your response

 

[mitchellde]

Hi Everyone,

Does anyone have any suggestions on the appropriate primary diagnosis code you would use to bill a visit where the patient was seen for follow up after a fall. I work for a medical practice within a long term care facility and after a fall it is suggested that you see a MD/NP for a follow up after a fall even if there is no injury. Insurance company does not like when codes that fall under the W01 (fall on same level from slipping,tripping and stumbling) is used.

Thank you all for your response

Codes beginning with V, W, X, or Y ( chapter 20) can never be the first-listed or primary code on a claim. You can use the Z04.3 first listed ( first listed only allowed) followed by the W01.-- code.

 

[kcouncil]

Codes beginning with V, W, X, or Y ( chapter 20) can never be the first-listed or primary code on a claim. You can use the Z04.3 first listed ( first listed only allowed) followed by the W01.-- code.

Thank you so much. Z04.3 is the code that I told my providers in my office to use. I wanted to make sure I was correct because I have to provide coding training to the providers regarding how to report these type of encounters.