Wiki DOT physical/form completed

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Lisa Bledsoe

True Blue
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Greeley, Colorado
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I'm in a quandary here...
Our Senior Medicine doctor did a DOT physical on a Medicare patient and coded 99397. Of course it was denied by Medicare so now the patient is getting billed or the visit. He does not feel that it was worth $200 for what the doctor did. She completed his form which includes a history and exam and marked that due to hypertension he would need to be re-evaluated in one year. The documentation I am looking at meets the preventive medicine criteria as far as I am concerned. How would you all deal with this situation? Thanks in advance.
Lisa
 
Hi Lisa -
Our DOT's are charged at a "lower" rate than say the 99397 - sometimes our providers use the preventive E/M's other times they use the Office Visit E/M's - either way, "internally" they are lowered -our DOT exams (and paperwork completed) are $120.00 and we use the V70.5 dx code. We do have a contract with our local firefighters and bus drivers - their DOT exams are even lower - at $70.00. Typically, they aren't as detailed as a regular physical, there is some paperwork involved - and usually just a urine test. (though our firefighters do get a chest xray also).
aaaaaanyway -
our DOT's are lower than our normal preventive service or office visit E/M.

(I wouldn't like paying the $200.00 either!) :) I would talk to somebody about fixing a lower rate for DOT exams. ...
 
We do not bill DOT's to private/personal insurance. Ours are done as an occupational health. They are either billed directly to the employer who is requiring this or they do to patient. We do not bill personal insurance for this.
 
99213. we also had talk of using the prevent codes, but we didnt want to charge that much. This has been a tough subject for us.
 
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