Wiki Preventive visit with no PEX?

[ca_cpc]

We have a patient contesting her copay because she came in for a PEX and we did not bill it as preventive. The provider did not do a full physical, just the following:
"General:
well developed, well nourished, in no acute distress.
Heart:
non-displaced PMI, chest non-tender; regular rate and rhythm, S1, S2 without murmurs, rubs, or gallops"

I have verified with the provider that she did not do a more extensive exam. There is no ROS, but some gyn history is documented, as well as our usual "Well care template" with auto-populated last dates of service for various tests, etc.
She also ordered labs for the patient's hypothyroidism, which is what we wound up billing for. (A 99212 - barely).
The patient is insisting that since she was scheduled for a PEX, that is what we need to bill it as. I do not see any way this can be billed as a preventive visit, but does anyone else see a way around this? I want to make sure I have all my ducks in a row, especially since the patient in question is also a medical provider and I want to make sure I can answer all her questions clearly.
Thanks!

 

[mitchellde]

We have a patient contesting her copay because she came in for a PEX and we did not bill it as preventive. The provider did not do a full physical, just the following:
"General:
well developed, well nourished, in no acute distress.
Heart:
non-displaced PMI, chest non-tender; regular rate and rhythm, S1, S2 without murmurs, rubs, or gallops"

I have verified with the provider that she did not do a more extensive exam. There is no ROS, but some gyn history is documented, as well as our usual "Well care template" with auto-populated last dates of service for various tests, etc.
She also ordered labs for the patient's hypothyroidism, which is what we wound up billing for. (A 99212 - barely).
The patient is insisting that since she was scheduled for a PEX, that is what we need to bill it as. I do not see any way this can be billed as a preventive visit, but does anyone else see a way around this? I want to make sure I have all my ducks in a row, especially since the patient in question is also a medical provider and I want to make sure I can answer all her questions clearly.
Thanks!

Does the chief complaint show that the patient presented for a well visit with no complaints? if so then shame of the provider for not providing what was requested. If the patient expressed symptoms and that is what the provider addressed then it is not a preventive and the provider is correct. Just because labs for hypothyroid were ordered does not make it a visit for hypothyroidism. There must be more to this story.