Question Coding problom ! How do you codes for AWV, Sick Visit and Risk reduction therapy same day?

mankwan

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I am working at Internal and pulmonary disease and allergy immunology office. Can I bill AWV, Sick visit and risk reduction therapy as same day? Thanks !
 

lcolborn

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Yes you can bill all that if the AWV cannot be rescheduled for another day since it's also a sick visit. A separate documentation that warrants a visit is advisable to separate the Healthy visit and the sick . 25 modifier is appended on the E/M .
 

mankwan

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Yes you can bill all that if the AWV cannot be rescheduled for another day since it's also a sick visit. A separate documentation that warrants a visit is advisable to separate the Healthy visit and the sick . 25 modifier is appended on the E/M .
Thank you so much Icolborn.
 

mankwan

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Yes you can bill all that if the AWV cannot be rescheduled for another day since it's also a sick visit. A separate documentation that warrants a visit is advisable to separate the Healthy visit and the sick . 25 modifier is appended on the E/M .
Yes you can bill all that if the AWV cannot be rescheduled for another day since it's also a sick visit. A separate documentation that warrants a visit is advisable to separate the Healthy visit and the sick . 25 modifier is appended on the E/M .
Can i codes for G0439 (AWV medicare established pt.,) 99213-25 (sick visit with 15 mins). What will be appropriate code for "risk reduction therapy" ?thanks
 

lcolborn

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GO439, 99213(25) is billable as long as there is proper documentation and the need for the sick visit to show the distinction of the two. .
~ Refer to your CPT book for the risk factor reduction...., there's quite a few, depending on what was done ( it could be preventive counseling/ 99401-99404 or Behavior change interventions 99406-99409 etc. ). And whatever code you chose, it goes after the G code.
 

SharonCollachi

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As a patient, this is incredibly discouraging to have to make 2 trips to the MD just because the insurance companies frown on it. Sad that medical care has come to this.

You know, I have never combined an annual physical and other problems for my own doctor visits, and I'm in my 50's (meaning, I've been going to doctors for a lot of years). Is it not sad that people now think it's okay to do that? You schedule a physical, and that's what you get, a physical. If you have other problems, you schedule another appointment.

We could always go back to the old days when the patients sent in their own superbills and had to fight for payment themselves.
 

fwnewbie

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Scheduling two visits didn't bother me until I developed a debilitating disease making 2 trips an exhausting prospect. I'd be likely to forgo the physical and only see the MD when a problem arose, thus defeating the purpose of preventative medicine and returning to a "put out the fires" mentality. And Medicare pushes their clients get that annual physical but how does that help all individuals? I really don't know what the answer is; just venting I guess.
 

mankwan

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Scheduling two visits didn't bother me until I developed a debilitating disease making 2 trips an exhausting prospect. I'd be likely to forgo the physical and only see the MD when a problem arose, thus defeating the purpose of preventative medicine and returning to a "put out the fires" mentality. And Medicare pushes their clients get that annual physical but how does that help all individuals? I really don't know what the answer is; just venting I guess.
Fwnewbie, Thank you very much for all your help and great information.
 
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