Office visit plus health maintenance screenings

kbrooks15

Contributor
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11
Location
New Haven, CT
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When a patient comes in for a specific complaint in an office visit and a provider wants do routine labs in addition to the visit unrelated to the complain. Are those coded with screening codes specific to what they are looking for? I've been seeing providers not understanding why they shouldn't use a code like Z00.00 for routine labs when it is not a preventative visit.

I want to confirm the correct way of coding this to be sure.
 

sujaya101

Networker
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40
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It depends on the payer. Some pay routine labs with Z00.00 others don't. Fr eg, Medicare & Aetna have lots of guidelines in place fr lab tests. Check payer specific rules b4 submitting claims.
 

kbrooks15

Contributor
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Location
New Haven, CT
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Even if it is not a preventative visit? They would pay with a 99213 and Z00.00?

I'm going to check but I'm not familiar with that happening.
 

sujaya101

Networker
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I misunderstood you. I thought 99397+99213. No in that case labs should be denied. Providers need to be educated that for a problem focused visit, specific dx should be on lab claims. Thanks
 
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