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Annual Preventive Exam vs WWE same day appts

  1. Question Annual Preventive Exam vs WWE same day appts
    Medical Coding Books
    Here is the problem:

    Female patient comes in for an Annual PE with her PCM, turns out that her provider is not comfy doing paps (neither is she, she prefers for a female to do this). So, she is scheduled for an WWE either on the same day (same clinic/diff provider) or she can have an appt a few weeks from now.

    The Annual PE is completed & a preventive E&M is assigned. If the same day WWE is kept how should this be coded & how should it be coded a few weeks from the original appt (another prev?)?

    Is it possible (legal) to code two, same day annual health checks (PE/WWE) appt as preventives? Is it possible to code these appts within a few weeks/months of each other?

    Medicare/aid does not apply in this case.

  2. Default
    It would not be wise to code and bill for both. Many commerical insurance will deny as well. Only code and bill for services that were provided.

  3. Default
    Thanks for responding,
    but these 2 appts actually happend & now both providers are determined to code their appt as preventive E&M exams! I told them that this would not be correct & could eventually be taken the wrong way by someone (auditor)!
    Since these appts did happen, could I code one with an preventive E&M and the other as a reg outpt visit, or should one be coded with 99499 since it is a scheduled procedure (pap)??

  4. #4
    I'm not sure I understand. You want to bill a PE, a WWE, and a E/M on the same day? That I don't think you can do but you can bill a PE with and E/M or a WWE with an E/M. Medicare has been paying E/M's bill with WWE billed by my office.

    Whats a PMC? Primary medical clinician?

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