Wiki Pessary Cleaning Visit MDM?

[toria11]

My providers are stating that in the past they would bill these visits as a level 4 because they are doing a pelvic and UA on them every time, removing the pessary cleaning it and replacing it. How would you level these visits with the new rules?
I would say the best option would be to document time and level based on that but if using MDM, where would this fall for an established patient?
Thanks.

 

[lgardner]

we bill these as a 99212 or 99213, depending on documentation.
a pelvic exam and and a ua (which I am guessing is billed in the office?) would not reach a moderate level of service (in my opinion).

** EDITED to add - I don't think a pessary cleaning would meet the medical necessity of a Moderate level of service.

here is an older article from Codapedia (not my favorite source):
"If a patient returns for the cleaning and re-insertion of a pessary, bill with an office visit code. The patient is typically established, so use a code in the 99212-99215 series of codes. If the patient has no problems or complaints, these visits will often audit as a 99212."

 

[tori.a]

Thank you so much! I agree completely-- this is the answer I gave them. It definitely varies case to case but without any other complaints/issues I think a level 3 (at most) would be appropriate.

 

[csperoni]

I answered in your original post https://www.aapc.com/discuss/threads/pessary-cleaning-visit.190613/ before seeing this answer, which is basically the same as mine.