Medical Billing Coding - Need help preventive medicine, cpt, codes
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Thread Topic: Need help preventive medicine
Topic Originator: conti
Post Date August 8, 2007 @ 8:23 AM
Need help preventive medicine

August 8, 2007 @ 8:23 AM Reply  |  Email Friend   |  |Print  |  Top

I need to understand something regarding on what my doc is doing..
He does a head to toe exam because the patient comes for a "physical" he does counseling in safe sex, seatbelt use and alcohol and drugs. He writes if patient has immunizations up to date. But the patient has a bunch of staff going on and they are no mention until the assessment and plan.
For ex: CV: pt on medication XXX for BP will check in two weeks
Endo: DM pt glucose is 343. something else (very hard to read handwritting) in two days he will follow in two weeks when stable
and another system or problem similar amount of info.
He refers pt to GI.. He writes v70.0 401.1 250.42 and 272.0
Is this consider part of the "annual exam" he should be billing and documenting differently? Does he needs to mention all those dx?
He does most of the physical like that  Your thoughts? Please help.

Linda Buffington
August 31, 2007 @ 3:33 PM Reply  |  Email Friend   |  |Print  |  Top

IF the provider does a referral, or script or tests for a condition during a physical the appropriate level E&M should be billed in additon to the preventative age specific code, use a 25 modifier on the E&M code.

Sarah, CPC
September 20, 2007 @ 9:41 PM Reply  |  Email Friend   |  |Print  |  Top

The key with billing a separate E/M 99212-99215 in addition to the preventative CPT code is that the sick visit work-up must be a significant service from the physical.

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