Wiki Does anybody know?

[anggand@aol.com]

Is it illegal to charge an insurance for an E&M visit if pt is scheduled for a form to be filled out. (example a Social Security form) My boss seems to think that we can bill pt's insurance for a 99211 or 99212?? help she's doing this alot!

 

[RebeccaWoodward*]

See if 99080 is a better fit...

 

[amoviedo]

Strep Test CPT

Wha is the correct code to report Strp test in office 87430 or 87880?
Thank you for your help

 

[lauried]

Anggand,
I agree with Rebecca. We use 99080-special report. If you cannot meet the criteria for a visit, you cannot bill one. Go with the old phrase "Not documented, not done".

 

[karen4806]

Completing insurance forms

You should be using 99080 which typically is a non-covered service for insurance carriers and the patient will have to pay for the expense of completing the form. If you look at 99211 it specifically states "for the evaluation and management of an established patient, that may not require the presence of a physician. Usually the presenting problem(s) are mininimal...." This code would not suffice for insurance forms.

Also in order to bill 99212 you would need a problem focused history, problem focused exam, and straighforward medical decision making. It would be an error to bill this code for completing insurance forms.

 

[RebeccaWoodward*]

Wha is the correct code to report Strp test in office 87430 or 87880?
Thank you for your help

Rapid strep is 87880

 

[z3djinn]

I think you may be able to charge a 99211 depending on the Q&A needed to complete forms to commercial payers, so I wouldn't say illegal is an appropriate term. I personally feel that 99080 would be the better fit in most cases and just have the patient sign a waiver (similar to an ABN for medicare) stating that if the service is not covered by the payer, they will be balanced billed for the encounter.

If this was a very common request, why not require a flat rate fee of $50 due at the time of completion?

There are options here.