Korbc
Expert
Hey there!
I've see verbiage before that additional visits for complicated routine care can be separately billed when unmanaged diabetes, htn, etc are addressed but if it's a routine visit and it involves adjusting any prescriptions, they have these unmanaged conditions, they're going over diabetic logs and spending a lot of extra time and it's not exactly routine care any more am I able to charge a problem e/m for that despite it being a scheduled routine visit and no additional visits were made for the problem. CPT states for these "additional resources may be reported separately" so i would just bill for the separate e/m portion of the visit that was not routine? I've just seen other strict dialogue on this saying if it's at a routine visit i can't bill seperatly unless it's of course a something like a yeast infection or uti and not exactly pregnancy related but just wanted to make sure if it was pregnancy related like gestational diabetes that is unmanaged that i could charge for the extra care being given? I know some of this is payer specific also and I've read some payer policy on this and this scenario isn't mentioned in some of the payer policy
thanks so much!
I've see verbiage before that additional visits for complicated routine care can be separately billed when unmanaged diabetes, htn, etc are addressed but if it's a routine visit and it involves adjusting any prescriptions, they have these unmanaged conditions, they're going over diabetic logs and spending a lot of extra time and it's not exactly routine care any more am I able to charge a problem e/m for that despite it being a scheduled routine visit and no additional visits were made for the problem. CPT states for these "additional resources may be reported separately" so i would just bill for the separate e/m portion of the visit that was not routine? I've just seen other strict dialogue on this saying if it's at a routine visit i can't bill seperatly unless it's of course a something like a yeast infection or uti and not exactly pregnancy related but just wanted to make sure if it was pregnancy related like gestational diabetes that is unmanaged that i could charge for the extra care being given? I know some of this is payer specific also and I've read some payer policy on this and this scenario isn't mentioned in some of the payer policy
thanks so much!