Wiki Preventative to E/M

[genesis.mccray@nyulangone.org]

Does anyone know if we are allowed to down code a preventative visit to an e/m if the chart notes does not support?
I was always under the impression that we were not allowed to do per billing/coding guidelines.

 

[lgardner]

Does anyone know if we are allowed to down code a preventative visit to an e/m if the chart notes does not support?
I was always under the impression that we were not allowed to do per billing/coding guidelines.

this depends, (mostly) entirely, on the documentation.

a preventive visit might change to an E/M, for many reasons, BUT it is important to realize that there could be consequences.
pt would, potentially, be billed for a copay, or the visit may be applied to their deductible.
and there would need to be a CC/reason for visit (amongst all other related documentation) that supported an E/M instead of a preventive visit.

also, your practice may have a policy addressing this issue.

I know this answer is as clear as mud, but I hope it helps.