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annual physical

  1. #1
    Question annual physical
    Exam Training Packages
    when a pt comes in for a physical can you link other codes to the preventive

    example:

    99396
    v70.0
    401.1
    272.4
    v58.69

    or would you use an E/M visit for the 401.1, 272.4, V58.69 Trying to clear it up for the physicians. The only diag. code that we link to the 99396 is V70.0.

  2. #2
    Default
    If and only if the provider performed a significantly separate service would I link the additional diagnosis to an E/M code. If the conditions were just addressed at the physical I would just link them to the preventative code.
    Christina Lee Wagner, CPC, CPC-H

  3. #3
    Location
    NCF Gainesville
    Posts
    64
    Default
    I agree with Christina. But definitely, if the provider performed a seperate E/M for the problem focused visit, make sure they are billing that too, with the 25 modifier.
    Jeni Smith, CPC, CPMA

  4. #4
    Default annual physicals
    Has anyone coded "annual physical" for a 43 YOwomen getting a pap/pelvic as
    99396
    G0101
    DX: V72.31

    i have never used the G0101 with my 99396 and recently learned that my Bc/Bs carriers allows it!

  5. #5
    Default G0101
    Tammy,

    I have never used G0101 on commerical ins only on medicare patients. Did not know you could use that code for commerical. I only use v72.31 if it is a complete pelvic and breast exam.

  6. #6
    Default G0101
    Tammy,

    I have never used G0101 on commerical ins only on medicare patients. Did not know you could use that code for commerical. I only use v72.31 if it is a complete pelvic and breast exam. I use v72.46 if it is just a collection of Pap.

  7. #7
    Location
    NCF Gainesville
    Posts
    64
    Default
    I have always been told G codes were Medicare codes. Might want to look into that, BCBS might be asking for that $ back
    Jeni Smith, CPC, CPMA

  8. #8
    Default
    Quote Originally Posted by jas0426 View Post
    I have always been told G codes were Medicare codes. Might want to look into that, BCBS might be asking for that $ back
    You'd be surprised at how many "commercial" insurance recognize those G codes and Q codes. Our office made phone calls to our "top 10" carriers to find out if they reimbursed these codes and more than 2/3 of them do.

    I would say to check with your carriers to find out.

    Good luck,
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  9. #9
    Location
    NCF Gainesville
    Posts
    64
    Default
    Wow, that is so good to know. I will definitely tell by A/R director about this to see where we might be missing out.
    Jeni Smith, CPC, CPMA

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