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E/M code for a "Missed Appointment" ??

  1. #1
    Salt Lake North
    Smile E/M code for a "Missed Appointment" ??
    Medical Coding Books
    Our doc wants to bill for a patient that missed their appoinment and did not call in. Are there CPT/ICD9 codes for this?

  2. #2
    Kingsport, TN
    If you bill Medicare you will need to check their requirements for billing this fee before proceeding. Medicare does not pay for this fee and most other carriers follow Medicare guidelines and would not pay as well. The code we use in my state is in the medicine section. 99199 Anyone else?

  3. #3
    We use CPT 99199 to bill patient's for No Show visits

  4. #4
    Medicare does allow for you to bill the patient for a no show. You do not need to bill anything to medicare. They just require that you do for all patients not just the medicare patients. it needs to be a policy for your office and is best if you have a paper that the patients sign saying they understand that if they do not make there appointment they will be charged. We charge 50.00 for a no show or cancelled appointment < 24 hour notice
    Herbie W Lorona Jr., CPC, CPC-H

  5. #5
    Duluth, Minnesota
    medical insurance won't cover a failed appointment (it's not medical if they don't show)- the charges are billed out to the patient. Of course there should be a policy in place that the patient is aware of which states "patient will be billed for no-show/no call cancel appointments"...
    at least that's the way it is here...
    Donna, CPC, CPC-H

  6. #6
    we don't use CPT's .. we have an internal or 'in house' code like "NCNS" (no call, no show) or something thats keyed in and a bill automaticaly shoots out to the patient .... normally between $40-$50 ...... and you'd have to include this in your 'practice policies' and be able to prove somewhere that the patient knew of it. normally, we have them sign or initial all of our practice polcies. If they are an established patient (meaning you have a signed guarantee of payment) you can take legal action if they refuse to pay. for a new patient (even though you have no guarantee of payment form) you can certainly still bill them if you have their demo information, but you cannot take legal action.

  7. #7
    Loma Linda California
    Default DX for Missed Appointments
    What diagnosis code do you use for missed appointments. My guess would be the reason for the visit.

  8. #8
    Columbia, MO
    There is no code really and you do not submit this to the carrier you bill the patient. Make sure your contract allows this and most contracts require that you have a visible notice posted for your patients to be able to read your no show policy.

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
    We don't use any diagnosis codes because we don't bill this to the insurance company. We have a internal code we put on the claim just to add the charge for the no show and we send a bill to the patient.
    Herbie W Lorona Jr., CPC, CPC-H

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