Scenario: New patient comes in to establish care. She has not been seen by a dr in years nor had lab. Provider orders routine lab with no complaints and no previous dx. Is Z00.00 the correct ICD-10 code for this type of visit? A coworker (not a coder) says it is not a valid code and lab will be denied by insurance (Humana). Thank you!
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Tag Archives: visit
Do You Know What an Annual Wellness Visit Is?
Annual Wellness Visits (AWV) are covered by Medicare annually, but they are often confused with other types of examinations, so the Centers for Medicare & Medicaid Services (CMS) has published an MLN booklet to help medical coders and their providers keep them all straight. Annual Wellness Visit Components AWVs are only provided annually. The AWV […]
The post Do You Know What an Annual Wellness Visit Is? appeared first on AAPC Knowledge Center.
colonoscopy pre op visit
I am new to gasto coding and have a question. It is my understanding we cannot bill for the pre op visit for a colonoscopy if it is done within 24 hours as the pre op is part of the colonoscopy service. But help me with these scenarios. The patient goes to the family doc because they are age 50+ and want their screening, the family doc refers them to the surgeon who then evaluates and does exam on the patient and schedules them for a screening colonoscopy in 2 weeks. Can we bill for the exam done by the surgeon since the colonoscopy is not scheduled for a couple of weeks out?
Second scenario, the patient went to see the surgeon for rectal bleeding, surgeon decides to do a colonoscopy in 2 weeks, he did an exam and ran blood work to verify his diagnosis. Can we bill for the surgeons visit? Does it make any difference if the patient went to see his family doc first and the family doc referred him to the surgeon for evaluation?
Thanks for any help you can offer I am trying to figure out when I can and cannot bill
Billing Office Visit + other and then only getting reimbursed the smaller amount
I’m trying to bill a 99213 along with an 81000. I’m getting messages from the carrier that they’re paying for the 81000 and bundling the 99213 under it (so I’m being reimbursed less than $ 10 for a service over $ 100). Is providing a modifier 25 for 81000 a way to get around this?
Thank you!!
Physical therapy insurances that only pay for evaluation on first visit
I’m having a hard time trying to find information about which insurances will only pay for the evaluation code for the patient’s first visit with physical therapy. Does anyone know what the insurances are or where I can find that information? Thank you!
Need Help Coding Podiatry Office Visit
Hi Everyone –
Can someone please assist with coding this visit note? I am getting 5 different answers from my coding team of 5 coders.
99212 – is this separately reportable, why or why not?
11720 – is this separately reportable, why or why not?
G0127-XU – is this separately reportable, why or why not?
In your opinion, what would be the final coding.
Link to office visit note: https://drive.google.com/file/d/1IvO…ew?usp=sharing
This is for WYOMING MEDICARE
Thanks in advance for any help with this.
Billing Medicare Wellness with office visit
I work for a group of family practice providers. One has asked me if he could charge a subsequent Medicare wellness visit (G0439) with a NEW patient office visit (99204) for the same encounter. Commercial payers will let me charge an office visit with a NEW patient wellness visit, BUT ONLY IF the office visit used is an established code (ex: 99386+99213=OK; 99386+99203=NOT ok). Is Medicare the same? That is, G0439+99213=ok, but G0349+99203=NOT ok? I haven’t found any CMS policy one way of the other on this, it’s just how I was trained. If you know the answer, great! If you have a reference, even better. (This particular provider wants very much to document and code properly, but he’s very much into "prove it to me/show me the guideline.") Thank you,
Copay for Office Visit
If you send a patient to the ER are they still responsible for the office visit copay?
Circumcision and Preventative visit
Chief complaint: weight check & circumcision
HPI formula feeding, gaining weight, appropriate responses..
Full ROS; negative as per HPI
Exam; comprehensive
Procedure note for the circumcision.
Assessment plan;
patient gaining weight appropriately
continue vitamin d exposure with sunlight
post operative care for circumcision.
Mention of next appointments
HPI formula feeding, gaining weight, appropriate responses..
Full ROS; negative as per HPI
Exam; comprehensive
Procedure note for the circumcision.
Assessment plan;
patient gaining weight appropriately
continue vitamin d exposure with sunlight
post operative care for circumcision.
Mention of next appointments
Would it be supported to bill for a ‘weight check’ Z00.111 99391 with the circumcision in the absence of a problem per se? Are weight checks in and of themselves necessary for babies? If a full history and exam are done at a circumcision is that enough for a wellness check if the chief complaint states "weight check and circumcision" ?
Thanks!
Positive Feccal Occult test and pre-screening visit
A patient has a positive fecal occult blood test (FOBT) and is referred to GI for a colonoscopy. Can the GI physician bill for a pre-screening visit? In many cases the only symptom may be a positive FOBT. This question has come up several times in the past few weeks and am having trouble finding a definite answer or even a generalized answer
Thanks!!
Dolores