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Wiki E/M vs. Wellness visit

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abhobson@yahoo.com

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I work at a Dermatology practice and I have had several patients call and ask why they had a copay for a "wellness visit." What is the CPT or ICD-9 code(s) to use for a wellness visit vs. E/M code 99212? What constitutes a wellness visit?
 
We were having a similar issue - pt is coming in for a yearly skin cancer screening. However, in dermatology we can only use E/M code, so we bill that with the diagnosis of V76.43 for special screening for malignant neoplasm skin and if the patient truly has a 100% cancer screening policy for yearly checks, they pay it at 100%.
 
At our clinic we also use E/M visits with the V76.43 and we get paid 100% of the time. It seems though there is always a finding, most benign, so we code the dx appropriately.

Jen Verlinda, CPC
 
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