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Split billing for physical and obesity

  1. #1
    Default Split billing for physical and obesity
    Medical Coding Books
    Hello everyone: I am coding this chart where Dr. is trying to bill a physical exam 99395 along with 99213 but the only problem the patient have is obesity, no complaint at all, I don't think this is a split bill he did prescribe some vitamins but patient obesity is stable. Any sugestion on how to reply to this Doctor.
    Mildred Nieves, CPC

  2. #2
    That is a tough one. I don't think that is qualifies for a split billing either since he didn't really perscribe any medications for the obesity or lab orders to find the cause of the obesity or a referal to a dietician. I am not sure what you would tell the doctor though. If it were me I would tell my doctors that the obesity was not treated so it does not justify a "sick visit". It would just be considered inclusive to the "well visit" discussion.

  3. #3
    Thanks Arnorld I totally agree with you.
    Mildred Nieves, CPC

  4. #4
    Our books state if work up is required you may bill, I dont see what work up was done ,plus most insurances do not cover obesity as a primary diagnosis. We also inform our pt for 2 E&M billing.

    If an abnormality is encountered or a preexisting problem is addressed in the process of performing this preventive medicine E&M service and if the problem or abnormality is significant enough to require additional work to perform the key components of a problem-oriented E&M service then the appropriate office code should be reported.

    An insignificant or trivial problem/abnormality that is encountered in the process of performing the preventive medicine E&M service and which does not require additional work and the performance of the key components of a problem–oriented E&M services should not be reported.

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