Wiki tricare diagnosis code for well person exams

[ldove]

Is anyone else having difficult with Tricare lately when it comes to preventive visits? Is it true they no long are accepting well person/routine exam diagnosis codes? I spoke with a representative at Tricare and they say they want a more specified code.

 

[slivingston]

Our office recently came across this denial as well and when we called we got a very rude service rep who told us to 'Just change the coding to get it paid'. Needless to say we called back and when we spoke to another rep he told us that the patients' individual plan did not cover routine visits at all. So we coded correctly but the patient doesn't have coverage for routine PE's. I would suggest maybe calling back to see if you can speak with another rep or maybe the supervisor.