Wiki Preventive Visits

[Watkins.Jess]

I am seeing where a patient comes in for a wellness visit but they are no eligible for one due to already having on this year. I know to change the prev code to an e/m code BUT the problem is, there are no dx's listed. The pt is healthy with no conditions or problems. What dx do I use for this scenario?

Currently coded with 99396 with Z00.129 and Z68.52

 

[csperoni]

You should not change your coding based on patient's eligibility. The service provided is what should be coded. Changing your coding to incorrect codes for the purposes of receiving payment should NEVER be done.
Your practice should be verifying eligibility PRIOR to appointments.
My personal recommendation would be to not charge this visit as your practice provided a service you should have known would not be covered without informing patient of their responsibility.
Moving forward, I suggest:
1) Verify ahead of visits.
2) If patient not covered at this time for preventive but wants preventive, inform them and have them sign a no surprise bill form.