Primary Care Coding Alert

Reader Questions:

Let Patient Deal With Auto Insurer for Migraine After MVA

Question:

One of our patients has a 30-year history of migraines, but the migraines worsened after she was recently in a vehicular accident. She and the physician spent the majority of her latest visit discussing her migraines and their treatment. I think we should bill her health insurance because the migraines are a chronic problem; the patient thinks her auto insurance should cover treatment because the MVA made the migraines worse. How should we handle this?

Texas Subscriber

Answer:

You could explain to the patient that the treatment can be filed to her auto insurance if she has an open claim, although they probably will fight the liability for this diagnosis (346.xx for migraine and either E819.0 or E819.1 for the MVA). Require the patient to pay up front for the visit. Then file with her auto insurance company on her behalf, without an assignment on file and showing on the claim form that she paid your physician. When/if the auto insurer pays, it will pay her directly.

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