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Physician billing an Office Visit ...

  1. #1
    Location
    Woodland Hills
    Posts
    23
    Smile Physician billing an Office Visit ...
    Medical Coding Books
    Hello

    I have a lot of physicians billing me for an office visit, and the report they wrote up - while they saw the patient.

    Now, I thought if a physician bills for a report (and an office visit), the report has to be "Out-Of-the-Ordinary" ... otherwise, the report is part of the office visit payment.

    Any help would be much appreciated ...

  2. #2
    Location
    Columbia, MO
    Posts
    12,843
    Default
    What kind of report are your speaking of?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Woodland Hills
    Posts
    23
    Default Just a Regular Doctor's Report
    Hello

    Thanks for responding to my question ...

    I have these doctors - who will bill for an office visit, and then also bil for the report they generate from speaking with the patient (history, medical-decision-making, etc).

    Thanks

  4. #4
    Default
    That report sounds an awful lot like a medical record for the encounter, in which case they have to do that at minimum to even get paid for the office visit. If they write a special report about an independent interpretation of a diagnostic report/results, it contributes to the MDM of the E/M, if it was relevant and necessary. If it's really extensive, you can try to bill 99080, but it's probably going to deny - that's mainly utilized by Work Comp. Hope that helps!

  5. #5
    Location
    Woodland Hills
    Posts
    23
    Smile Work Comp ...
    Hello

    Would you elaborate on Work Comp ?

    That's exactly what I am doing ... and I wonder if these doctors who are billing me for their reports (the report for the office visit encouter) ... are payable.

    I thought exactly as you say ... "The report is part of the office visit encounter, and is not paid separately."

    But, for Worker's Comp .. maybe it's different ? ...

    Thanks

  6. #6
    Location
    Columbia, MO
    Posts
    12,843
    Default
    A lot of times for work comp it is different. It depends on your state. If you are involved with work comp then you need to get your states work comp manual for providers. You can get a ton of information from this on specific work comp coding and billing issues.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Location
    Columbia, MO
    Posts
    12,843
    Default
    A lot of times for work comp it is different. It depends on your state. If you are involved with work comp then you need to get your states work comp manual for providers. You can get a ton of information from this on specific work comp coding and billing issues.

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    Arrow Just wanted to add...
    Quote Originally Posted by mitchellde View Post
    A lot of times for work comp it is different. It depends on your state. If you are involved with work comp then you need to get your states work comp manual for providers. You can get a ton of information from this on specific work comp coding and billing issues.
    Google your state's department of insurance, division of worker's compensation, and search within the website for provider reimbursement policies and procedures. Hope that helps!

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