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99173

  1. #1
    Unhappy 99173
    Medical Coding Books
    Help...
    pt comes in for routine exam v700 (99215) and has eye exam v720 (99173) but it was the charges were denied...

  2. #2
    Location
    Columbia, MO
    Posts
    12,940
    Default
    When you say routine exam, are you referring to annual wellness? If so you do not use the 99215 for this you must use the preventive codes for the appropriate age. As far as the eye exam, it is probably being bunc]dled with the ov.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default 99173
    Thanks...
    So If I bill 99387 v700 remove v720 (99173) we should get paid?
    I did mention this is a humana/ medicare pt
    Last edited by perkins05; 12-29-2010 at 09:22 AM.

  4. #4
    Location
    Columbia, MO
    Posts
    12,940
    Default
    I am saying regardless of the payer, if this is a visit for an annual physical, then you cannot use the 99215 for the visit it is preventive and must be coded that way, will the payer pay?.. if it is Medicare then no not until visits after Jan 1 1. Until then it is patient responsibility but that is the way it is suppose to be. As far as the eye exam, check the CCI edits to see if it bundles with the preventive.. I think it is but I am not entirely certain.

    Debra A. Mitchell, MSPH, CPC-H

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