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Wiki Help please on follow up visit for lab results

lverellen

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If there was a stupid question, this may be one of them. I am relatively new at OPT coding so bear with me. I have a physician who wants to bill for an office visit when he sees patients for follow up of lab results. He states he always sees the patient in the office following a lab result. I would like to advise him with the following scenarios but would like someone to review them to see if I am correct with my line of thinking:

1. If the physician is seeing the patient in follow up for routine preventative labs, which are found to be normal, he/she cannot bill for a follow up visit as this would be an integral part of the visit where you ordered the labs, and therefore not separately reportable.

2. If the physician is seeing a patient in follow up for routine preventative labs that were found to be abnormal, or that diagnosed a disease that wasn't previously discussed and treated, AND you plan to make changes in your course of treatment you can bill for the follow up visit.

Now for my next question, does it matter which labs he/she ordered, and if they performed the labs in the office? Thanks in advance for the help!
 
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