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Office Visit/Prescriptions

  1. #1
    Default Office Visit/Prescriptions
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    Just heard an interesting conversation and I thought I would posted to get some feedback. A coworker is concerned because her insurance company is being billed for office visits, interesting thing is she has not gone to this particular doctor in over a year. She has called in for prescription renewals. When she called the doctor's office and question their billing department why her insurance company was being charged for office visits, she was informed that when writting the prescriptions the doctor can bill as an visit because it takes him that long.

    this does not sound right! any thoughts.


  2. #2
    If they are using 99211-99215 then no, this is not right and is in fact fraud.

    There are telephone E/M codes 99441-99443 but if the only thing that is happening is she calls the office leaves a message with whoever answers the phone and this prompts them to call in a script, these code are not appropriate either.

    I would suggest she call her insurance and advise them what is going on, they have the right to investigate any claims they have paid.

    Laura, CPC, CPMA, CEMC

  3. #3
    If patient come to the clinic for RX is it OK to code 99211

    Thank you

  4. #4
    Sorry Kumeena I have to disagree.

    The thread above has a couple of links in it about this. The Trailblazer one specifically says it is not appropriate when the only reason is for a script refill.

    Laura, CPC, CPMA, CEMC

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