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ICD-9 for immigration physical followup visit

  1. Default ICD-9 for immigration physical followup visit
    Medical Coding Books
    The provider that I bill for does a lot of immigration physicals. The first visit is normally billed out as a preventive visit. It is the follow up visit that I am having a problem with. Since most health plans have limited benefits for preventive visits, we are experiencing denials when using that code for the follow up. The provider will often give an immunization at the second visit using a V code. If he codes the visit with an E/M code and uses the V code as the primary diagnois, we are getting denials as well. Any idea as to what ICD-9 I could use to avoid these types of denials? I have searched the ICD-9 book and cannot come up with anything that would work. Any help would be appreciated. Thank you.

  2. #2
    Overland Park, KS
    I'll wager an opinion here.

    I would not consider an immigration physicial to be preventative in nature. I think this would be more of an administrative physicial. I would report this with code 99499 (unlisted E/M) and ICD-9-CM code V70.3. Payers more than likely won't pay for this, so you may have to make the patient a self-pay.

    Now for the follow-up visit, is the provider addressing a specific issue or complaint? If so, you report the E/M and code for the symptom or complaint. If not, then I could possibly see the follow-up visit being preventative and would report V70.0.

    Others may see this differently, but this is my opinion.

    Hope this helps.
    Last edited by dballard2004; 02-07-2011 at 02:44 PM.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  3. #3
    Default Physicials
    Working in the industry for as long as I have, I can tell you that many insurance carriers do not pay for physicials. I agree with charging the patient. I also feel that calling the insurance to see if the physical is a covered expense would save you time and trouble.
    Diana Wilson, CPC. CPMA, CPC-I
    PMCC Instructor

  4. Default Immigration physical coding
    Thank you for our response. We will most likely be going to self pay for most of these. I appreciate your input.

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