Wiki HELP is there a Code for large group Refractive surgery seminar

[driley6@hvc.rr.com]

We have a physician who performs Lasik PRK surgeries.
Once a month the have a seminar for all the West Point Cadets interested in
the surgery, anywhere from 30-200 cadets attend the 60 minute seminar for
refractive surgery options. Counceling covered multiple areas, to include
purpose of surgery, detailed anatomy of the eye, myopia, hyperopia, and
astigmatism. Qualification for as well as risks and expectation of each
procedure are discussed at length with the patients to include potential for
20/25 or better vision. Etc etc.

They would like to know if there is a code to capture this service as a
group. I looked at 99078 but not sure if this falls into this type of
counseling.

I was also told that the cadets who are interested would then come to the
clinic and be evaluated, at this point some may or may not qualify but I
think all the above will be discussed at that time also.

Please let me know ASAP

Thanks so much!

Diane

 

[mitchellde]

Exactly how do you plan to bill this? Are you sending claims to each attendee insurance? So then you are calling each attendee a patient of your practice ?

 

[CodingKing]

I don't think you can bill for this. Would there be a charge if the patient did not have insurance?

 

[driley6@hvc.rr.com]

Since they are military they will all have Tricare, not sure how this would be billed or if its even possible. I am trying to find out for the facility..and then myself since I code for this clinic.

Thanks for any imput!
Diane

 

[mitchellde]

I don't think you can advertise a seminar for information and then charge the insurance for the attendance. And then you could not charge a new patient encounter for the first patient provider encounter. Also I don't feel this was the intended purpose for that particular code. I don't have any resource in support of this nor any prohibiting it, however it just does not feel right.

 

[CodingKing]

I do recall seeing something like this in the past but it was free and you cannot collect insurance information when providing free services.

Here are a few examples of these being done free of charge:

http://www.ohsu.edu/xd/health/servi...ser-vision-correction/casey-eye-lasik-cal.cfm

http://laserlubbock.com/free-seminars/

http://www.illinoiseyecenter.com/about/events/

There are many more if you google "laser eye surgery seminar"

 

[thomas7331]

Even if you could find a way to bill this, which I doubt is possible, I'm almost certain you will not be able to get payment. TRICARE specifically excludes refractive eye surgery from coverage and generally only provides eye coverage due to illness or injury to an eye. Also, for most active duty members, all medical services provided off the base have to be coordinated and referred from the base's primary care providers in ordered to be paid and even then it's usually only to participating TRICARE providers unless none are available. You might direct this question to TRICARE or to the referral coordinator at the school to see if there some kind of program they have that would provide some reimbursement, but I don't know of any way you could code and bill this service in the traditional way of submitting to the insurance.

 

[driley6@hvc.rr.com]

The PRK's are being done on base, by Military Doctors....

I was just advised that they are capturing a similar situation for a women's wellness brief, here is how it described. They state that they are able to document/bill for this service as well as other providers bill for group services for let say counseling for a group of the wrestling team.


All female cadets were counseled in a group wellness brief for 60
minutes to include information on how to access medical care at Cadet Health
Clinic,how to access Relay Health and how to make online appointment
schedules .Cadets were counseled on recommendations for routine screening
cervical PAPexams to detect cervical cancer and the need for Chlamydia
screening for allADSM females How to prevent Pelvic inflammatory
disease/Sexual transmitted diseases/vaginal infections/UTI. All female
cadets were counseled on various Contraceptive methods available to
include emergency contraception and how to obtain prescription renewals for
medication and cadet pregnancy policy . Counseled on Vaccination
recommendations for HPV and Gardasil for the prevention of
HumanPapilloma Virus to include number of vaccinations required to complete
prevention. Cadet was counseled on how to report sexual assault and also
the tobacco cessation program available at CHC.."

Dx was counseling unspecified and I am not sure what the E&M code was for
group counseling 60 min.


I am trying to give them the correct info 100% as this will reflect on me if given the wrong answer.

Thanks for helping me out here...

Diane