# carve out



## codecrazy (Feb 15, 2010)

How do you carve out a office visit for a discovered problem when the patient was orginally just coming in for a physicial?


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## LindaEV (Feb 18, 2010)

This is really subjective...first I consider the problem...and if it really took extra time...did it really go "above and beyond"? If at this point I think maybe, I make a copy of the documentation and cross out everything that would belong to the preventative coding. Whatever is left I use to audit for a separate e/m code. At this point there is either enough to justify an extra charge, or there's not. Ideally, there really should be a separate note! I find the "extra" work, is really not that extra...especially if it is a finding as a result of the exam.


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## kamkole (Feb 19, 2010)

We struggle to determine what part of the exam would be considered "preventive" and what part would be "sick".  An example would be a 35 year old male coming in for a preventive visit, but also has hypertension and diabetes.  A hypertension exam is pretty detailed, but so is a preventive.  Thank you!


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