Wiki Multi Specialty (OB/GYN & Family Practice) Billing

[ahagan@thewomenspavilion.com]

We are new to Family Practice within our OB/GYN group. Would like to know when established patient sees OB/GYN for annual preventive care (incl Pap) what codes family practice phy use when patient comes in at a separate visit to see them for visit to establish themselves for primary care care physical, well woman labs, etc?

 

[Deb P]

PEs: For most insurances, while you use 9939x with dx V72.31, the family practitioner will use 9938x, but V70.0 for the dx. Medicare patients will have G0402 for the welcome to Medicare exam or if after 12 months of part B eligibility, G0438 or G0439. They will only pay one PE yearly regardless of specialty, so make your patient aware.
Also, I would call the patient's insurance to see if they will cover both a GYN PE & Primary Care PE in the same calendar year. Most insurances will, but that can be group specific...

Labs: If the GYN provider is doing the pap/labs, then CC a copy to the FP provider. Dx would be determined on the test.

Hope this helps!

 

[dorinda05]

I agree with Deb P!