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New patient, no problems, doesn't need a physical

  1. #1
    Question New patient, no problems, doesn't need a physical
    Medical Coding Books
    Ok, this is mostly a benefit issue but I'm thinking on it and would like other opinions.

    My doctor wants to see this patient while they are healthy to get a baseline but doesn't want them to wait for a year til they are due for their physical (just had one a couple of months ago).

    The cold heartless account rep in me says do the physical and bill it, if the benefits for well care are maxed that is a benefit issue not a coding issue, patient would be responsible.

    The coder in me says there really is no way around this being a screening visit so you can't use the new patient problem codes.

    My co-worker thinks we should bill this as a new patient problem visit with a dx of V70.3. Which I think will reject as well, and don't really agree with that type of V-code being used with a problem visit.

    Then the last option I can think of is for him to just do a meet and greet, no charge, but go ahead and get the papers signed to get the records from the other provider.

    Thoughts greatly appreciated,

    Laura, CPC, CEMC

  2. #2
    Your right without a cheif complaint it is considered preventive - can't charge the E&M.

  3. #3
    Milwaukee WI
    Default Meet n Greet
    I vote for the "meet n greet" option ...

    If I understand your post correctly the patient has just moved into your area and had a physical a couple of months ago. No complaints at this time, just looking for a new doctor. If this "non-medically-necessary" visit is being arranged at the physician's request, to establish the patient, then I would call this a cost of doing business and not charge anything.

    Remember if he codes a face-to-face visit at this time, all future appointments are established.

    Wouldn't he rather capture the new patient preventive the first time he actually sees this healthy patient for an exam?

    Hope that helps.

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 11-13-2009 at 12:17 PM.

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