Wiki 2 preventative visits in same year different provider

[candiced]

Patient came in for new patient visit with my provider and had her annual physical with her previous physician. I am aware we can only bill one preventative visit per year, but if my provider saw the patient and performed everything you would at a preventative visit can we bill it as a new patient visit instead?

 

[csperoni]

I would only possibly bill this as new patient if your physician addressed issues (chronic HTN, renewed rx, etc.)
If it was truly an annual preventive visit with no problems/complaints, I would not incorrectly bill that as new. I have to ask - why did the patient even schedule?

 

[Orthocoderpgu]

If the patient is coming in for a "New Patient Visit" and there are no medical issues addressed, then there is no medical necessity for billing an E/M. This is a different way of having a "Welcome to the clinic" visit or to "Establish Care'. It seems like your provider is having patient's come in to "Establish Care" and billing it out as a "Preventative Visit". I don't think you would want an auditor to see that as they might have some issues. But getting back to your question. If the patient is allowed one preventative exam per year, they won't care if a different physician is seen. Once they pay that one yearly exam, they will not pay another one. I am with Christine 100%. Why did the patient come in? What was the reason for the appointment? The answer to that could determine the code that is billed, or even determine if there is anything that is actually billable.