Wiki Perioperative Bariatric Evaluation by PCP

[eJones317]

We have patients who are required by their insurance to follow with their PCP monthly for 6 months (6 total visits) prior to having the bariatric surgery. The surgeon sends the patients to the PCP for these visits but it would not be a consult since the insurance is essentially the one requesting the visit. How would you code these 6 visits?

My thought is code a 99211-99215 (according to amount of documentation for each visit).
Use primary diagnosis of: V72.85 (Other Specified Examination)
Secondary diagnosis of: 278.01 (Reason for Surgery: Morbid Obesity)
Then code any other pertinent diagnosis: i.e. diabetes, hypertension, etc.

Does anyone have any insight or supporting documentation on this issue?
Any advice is greatly appreciated!

Thanks,
Erin

 

[purplescarf23]

medicare guidelines

Here is a link that should help you determine what the sequencing should be. You should not code the V72.83 first. Always the chronic problem with the patient then the V72.83 then whatever other problems the doctor is treating.

http://bbnor.noridian.com/Bulletins...er_12_2006/Clearance_for_Surgery_Requests.htm


Hope that helps.

Kelsey-CPC

 

[eJones317]

do you think it is correct to be using 99211-99215 for these visits since there are 6 of them over a 6 month period?

 

[purplescarf23]

I would not use 99211 to report any services by a provider(MD). 99211 is used primarily for nurse visits. So 99212-99215 would be appropriate. Hope that helps

Kelsey-CPC