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Thread: Can a Urologist Bill for This?

  1. #1

    Default Can a Urologist Bill for This?

    AAPC: Back to School
    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
    Join Date
    Apr 2007


    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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