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Can a Urologist Bill for This?

  1. #1
    Default Can a Urologist Bill for This?
    Medical Coding Books
    One of urologist had documented that the chief complaint for the visit is Prostate Screening. When the appt. was scheduled it stated Yearly follow-up. The urologist addressed ongoing symtoms such as impotence. The Urologist billed for a 99213, 36415, 84153 and 81001. The patient called back after the fact and stated that this should have been billed as a preventive medicine visit not an office visit. I think we are right by billing an office visit, but I am not familiar with preventive medicine visits. I've never seen this Urologist office bill for preventive.

    Can Urologists bill for preventive medicine visits? I was thinking maybe we shouldve used the G0103 with dx V76.44 for the prostate screening but the patient has BCBS insurance?

    I am really confused? Any suggestions?

  2. #2
    I agree, this doesn't sound like preventive medicine and I would not change it just to make the patient happy.

    I don't know why a urologist couldn't bill those codes but I have never really seen a service provided by a urologist that qualified. It may be a yearly follow-up, but it was due to a problem.

    I am guessing this is going towards a deductible or something to that effect and the patient doesn't want to pay for it, but if you bill it as a well check it would be paid.

    Laura, CPC

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