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Follow up Office Visit after Preventive

  1. Default Follow up Office Visit after Preventive
    Clearnace Sale
    I have a physician who performed a 99396 on a patient who had no other problems addressed during the visit and the only dianosis code to bill was

    Pt comes back for an OV to review his labs and the fee sheet has a 99213 and a diagnosis of F/U PE. I've reviewed notes for both visits and the pt is problem free and the notes say that. The OV was not time coded and I can not find a diagnosis and I believe that a V code will not get paid with a 99213.
    Am I right that if I send in the 99213 with only a V code for a dianosis that it will be denied?

  2. #2
    Milwaukee WI
    Default Where's the documentation to support charge?
    You say you reviewed the notes and the patient is problem-free and no time is recorded. Sounds to me as if there is no documentation to support 99213.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Columbia, MO
    It is not correct to say a V code will not work with an OV. But the problem I see here is there is no real necessity for this visit. Reviewing lab results is an inherent part of the visit where they were ordered. If the results are normal then you should not be charging an OV to tell the patient they were all normal. If the results indicate a new dx or a need to change a treatment plan then that is different and the documentation should state this so you would have a dx of abnormal lab or something to justify another office encounter.

    Debra A. Mitchell, MSPH, CPC-H

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