Is the CPT code at the confirmation of pregnancy visit determined based on the Reason for the Visit, or is it selected by the services performed?
One of my providers is routinely selecting a Well-woman's exam code (99384-99397) for the confirmation of pregnancy visits, and wanting to bill an additional 99213 for the confirmation of pregnancy itself. The documentation shows we did do a breast/pelvic exam, and she sometimes does a pap smear if it is due, but there Is no mention in the visit that the patient is here for a well-woman's exam.
My other providers code this as an office visit alone (99212-99214), even if they do a breast/pelvic exam and pap smear.
Any direction would be helpful! When I query the provider asking if the patient initiated a well-woman's exam during the encounter, the provider states that because she covered the elements she normally does in a well-woman's exam (breast/pelvic exam and pap smear), she is coding it that way. But in my mind, if the patient is here to confirm pregnancy, and we routinely do a breast/pelvic exam and review pap guidelines, then that doesn't make this a Well-Woman's exam.
Thank you!
One of my providers is routinely selecting a Well-woman's exam code (99384-99397) for the confirmation of pregnancy visits, and wanting to bill an additional 99213 for the confirmation of pregnancy itself. The documentation shows we did do a breast/pelvic exam, and she sometimes does a pap smear if it is due, but there Is no mention in the visit that the patient is here for a well-woman's exam.
My other providers code this as an office visit alone (99212-99214), even if they do a breast/pelvic exam and pap smear.
Any direction would be helpful! When I query the provider asking if the patient initiated a well-woman's exam during the encounter, the provider states that because she covered the elements she normally does in a well-woman's exam (breast/pelvic exam and pap smear), she is coding it that way. But in my mind, if the patient is here to confirm pregnancy, and we routinely do a breast/pelvic exam and review pap guidelines, then that doesn't make this a Well-Woman's exam.
Thank you!