Wiki contraception vs wellness

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becca12

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Hello,

A coder and I are having a discussion about whether if a patient comes in for contraception counseling if you would call it a wellness exam. The doctor does put on the top of her note the patient came in for a check up. But at the end of the note she doesn't even state that it is a wellness check. I told her that I wouldn't call it a wellness exam. So I am asking what other people have done about this issue.

Thanks
Rebecca
 
becca12 said:
Hello,

A coder and I are having a discussion about whether if a patient comes in for contraception counseling if you would call it a wellness exam. The doctor does put on the top of her note the patient came in for a check up. But at the end of the note she doesn't even state that it is a wellness check. I told her that I wouldn't call it a wellness exam. So I am asking what other people have done about this issue.

Thanks
Rebecca
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No I won't consider as a Wellness exam unless she write elaborate notes (papsmear and chlymidia was done/ordered etc., and littlebit more.. self check breast exam explined)
 
becca12 said:
Hello,

A coder and I are having a discussion about whether if a patient comes in for contraception counseling if you would call it a wellness exam. The doctor does put on the top of her note the patient came in for a check up. But at the end of the note she doesn't even state that it is a wellness check. I told her that I wouldn't call it a wellness exam. So I am asking what other people have done about this issue.

Thanks
Rebecca
Click to expand...

I would not consider or code this as a well exam, if it truly is a contraceptive counseling, the physician could bill this visit based on time 9921_-9921_ and there is a dx for contraceptive counseling I just don't have my ICD-9 book with me at the moment.
 
I wouldn't call it a wellness exam either, especially if no exam was done! I would also disagree with coding this as a problem visit based on time. If a patient comes in seeking counseling which is preventive in nature (contraception) and has no complaints, and all the provider did was advise and counsel, then the visit should be reported using the preventive counseling codes 99401 etc, and the visit is coded based on the time spent counseling, which s/b documented in the record along with a description. SOME payers, however, want you to report preventive counseling as a problem E/M along with dx code for family planning. If so, get it in writing because technically, it's NOT a problem visit and so the 992xx series of codes are not appropriate. Also, some plans don't cover the 994xx preventive counseling codes, and then responsibility for claim payment defaults to the patient. You have to do your homework on this, and also discuss with physicians/NPPs in the practice. Good luck...
Patricia, CPC, COBGC
 
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