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E&M billed with Z08

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kemmielynn

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Dubberly, LA
Is it appropriate to bill 99212 with only dx Z08 and Z85.820 or Z85.828 for a patient coming in for an annual follow-up for hx of skin cancer ? No other complaints or issues. My provider is looking for a policy to support this.
 
It's absolutely appropriate and correct to bill this, if these codes best describe what is documented. Cancers do require follow-up care even after it has been removed or is in remission, so an E&M service is supported if the provider determines that it is medically necessary.

Whether or not it will be covered by the patient's insurance is another question entirely. I've never heard of a payer that wouldn't reimburse this kind of follow-up care, but payers are quirky and their claims systems aren't always programmed correctly. But if you're looking for something in writing that says this can be billed and paid, you will need to check your specific payers' policies and plan documents to know sure.
 
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