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Thread: DOT physical/form completed

  1. #1
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Question DOT physical/form completed

    I'm in a quandary here...
    Our Senior Medicine doctor did a DOT physical on a Medicare patient and coded 99397. Of course it was denied by Medicare so now the patient is getting billed or the visit. He does not feel that it was worth $200 for what the doctor did. She completed his form which includes a history and exam and marked that due to hypertension he would need to be re-evaluated in one year. The documentation I am looking at meets the preventive medicine criteria as far as I am concerned. How would you all deal with this situation? Thanks in advance.
    Lisa
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Join Date
    Apr 2007
    Location
    Duluth, Minnesota
    Posts
    1,135

    Default

    Hi Lisa -
    Our DOT's are charged at a "lower" rate than say the 99397 - sometimes our providers use the preventive E/M's other times they use the Office Visit E/M's - either way, "internally" they are lowered -our DOT exams (and paperwork completed) are $120.00 and we use the V70.5 dx code. We do have a contract with our local firefighters and bus drivers - their DOT exams are even lower - at $70.00. Typically, they aren't as detailed as a regular physical, there is some paperwork involved - and usually just a urine test. (though our firefighters do get a chest xray also).
    aaaaaanyway -
    our DOT's are lower than our normal preventive service or office visit E/M.

    (I wouldn't like paying the $200.00 either!) I would talk to somebody about fixing a lower rate for DOT exams. ...
    Donna, CPC, CPC-H

  3. #3

    Default

    We do not bill DOT's to private/personal insurance. Ours are done as an occupational health. They are either billed directly to the employer who is requiring this or they do to patient. We do not bill personal insurance for this.

  4. #4
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Default

    Quote Originally Posted by 1073358 View Post
    We do not bill DOT's to private/personal insurance. Ours are done as an occupational health. They are either billed directly to the employer who is requiring this or they do to patient. We do not bill personal insurance for this.
    What E/M code do you use?
    Lisa Bledsoe, CPC, CPMA

  5. #5

    Default

    99213. we also had talk of using the prevent codes, but we didnt want to charge that much. This has been a tough subject for us.

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