First visit - how can they get a medically necessary 99204 for a deviated septum and post nasal drip? And how do they code 272.0 after the visit ("when the lab work came back") since it was not known at the time of the visit? If the patient asked for a physical and that is what was done, they cannot code a new patient visit. It must be coded for what was done. And, if they don't do "physicals" at the first visit how can they "get to know you"? Uusually a meet and greet/get to know you is for the patient to get to know the physician to decide if they want them as a provider or not, not the other way around. If he had scheduled for the post nasal drip and deviated septum this would be different...
Second visit - again, if a physical was requested and performed they can't code for a problem-oriented visit (unless they code for both preventive and e/m but if all is stable it would not meet the requirements for the problem-oriented e/m).
I find this unethical, but that's just me...
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