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Establish patient

  1. #1
    Default Establish patient
    Exam Training Packages
    I have a doctor who uses "to establish pt" as his chief complaint. He then goes on to discrible the patients whole history and that there are no chronic complaints. Some of them he reviews the treatment others have given or may check labs on the pt. Are these all preventative? The patients often refuse treatment on the items that he finds need treatment. Ex. erectile disfunction. Some do have prescription management but it is of another drs. script.

  2. #2
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    This sounds like a "get to know you" visit and is generally not billable.
    Walker Bachman, CPC, CPPM

  3. #3
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    The doctor is reviewing the patients condition and making recommendations. But the patient is just coming in to start a chart with the doctor. I say this is a preventative as a history, exam and mdm are made just not for a specific problem the patient said I need to see the doctor for my xxxxx problem.

  4. #4
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    I agree that from what you describe in your last post that it sounds like a prevent visit. If you want to bill it that way, you need to get your doc to do a more specific chief complaint.
    Walker Bachman, CPC, CPPM

  5. #5
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    sounds like preventative to me too.
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

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