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Billing for physicals when the GYN physical done elsewhere

  1. Default Billing for physicals when the GYN physical done elsewhere
    Medical Coding Books
    We are a family practice. Several of our patients schedule for physicals. When the doctor goes in the room, the patient states they had their GYN exam elsewhere and just want the physical. What codes are billed out by GYN physicians, and what codes are appropriate for the family practice to bill out?

  2. #2
    GYN doctor should be coding the 99213 along with well visit code. I will look them up and get back to you, can not think of them off the top of my head.

  3. #3
    Columbia, MO
    the family provider uses the V70.0 dx cde with the preventive vist level appropriate for age, the OB/gyn provider use the V72.31 with either the G and the Q codes or the preventive visit level depending on payer. the dx code by and large is what the payer uses to determine the benefits on the preventive levels.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    I usually use the appropriate age code for the routine preventative services and they still pay. Many insurances have told me that they know by the V72.31 that this is a gynecological annual and not a physical.

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