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probably an easy Preventive visit question?

ollielooya

True Blue
Messages
897
Location
Everett, WA
Best answers
0
Anyone around here on the weekend that can answer this question, or give some thoughts on how to deal with this scenario?

A patient comes in to see the Family Practice Physician's Assistant for her check-up wellness visit. He charges 99395. This pt has commercial ins. The next week the same patient comes into see her OB/GYN for her well woman visit and he does a pap & pelvic. He also charges 99395. Might this work? Looking for any input....or questions....I'm stalled.
 

mcnaryk

Guru
Messages
147
Location
Sacramento, CA
Best answers
0
Anyone around here on the weekend that can answer this question, or give some thoughts on how to deal with this scenario?

A patient comes in to see the Family Practice Physician's Assistant for her check-up wellness visit. He charges 99395. This pt has commercial ins. The next week the same patient comes into see her OB/GYN for her well woman visit and he does a pap & pelvic. He also charges 99395. Might this work? Looking for any input....or questions....I'm stalled.
I think both visits are coded correctly, but chances are her insurance is only going to pay for 1 visit at 99395. It's possible that the OB/GYN could just charge an E/M for their visit plus the pap and pelvic, but if they truly did a preventative exam, then 99395 is correct and the patient is most likely going to be billed for the extra visit. Usually women see the ob/gyn for their annual preventative exam, and maybe the family practice practioner for a chronic condition such as diabetes.
 
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