I have a Physician who regularly bills an Annual Physical (99395-99397) with an Office visit E/M(99212-99215). I have tried telling him the differences as to when and how this should be done and for the most part, he has cut down on billing an office visit(99212-99215) with an Annual Physical(99395-99397).
One scenario that keeps coming up however is when a Patient comes in for an Annual Physical, had bloodwork beforehand, is found to have "Vitamin D Deficiency" and then the doctor bills for the Office visit on top of the physical for treating the Vitamin D Deficiency (same goes for B12).
I don’t necessarily think that this qualifies as a significant, separate service but I’m not sure that I have a good argument against it. This doctor’s argument is pretty much, ‘well it’s a new diagnosis and I wrote a prescription for it.’ While I think about the patient receiving a copay or a deductible bill for this and trying to explain to them why they got a bill for Vitamin D deficiency. I think most people would be upset that they got billed separately for this but I can’t tell if I’m looking at this scenario objectively or not.
Is my doctor right in billing separately for this service along with an Annual Physical or am I right in thinking that there just isn’t enough work involved in diagnosis a Vitamin deficiency to bill separately for it?
Medical Billing and Coding Forum
