Wiki 99204 for no medical problem??

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theaterd

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I am closing superbills for other offices as well as the one I work in. The providers in another office continually charge new patients 99204. My problem is that in the note they say the patient has "no complaints".

There must be some standard for an initial visit, other than the "3" rule.
You can't charge a patient for a visit if they are just establishing with a new provider, and have no complaints, right?

Any information would be most helpful, and MUCH appreciated! :confused:
 
I would think that time spent would be major key using this code. Would it be a viable query to send the doctor. Having that documentation would help in an audit.
 
I would agree with you, to a point, but it still doesn't sit right that it's a level 4 with absolutely no complaint.
It seems unethical, which is why I was hoping that there was some other criteria that could be used.
 
Are they going to start managing any chronics? Not that that would make it a level 4, but just trying to think of something other than just time that might explain things.

Or as one of my former co-workers used to say, did an "oh by the way" come up? Maybe the patient made the appointment to establish care, but once they began talking during the visit there actually was something going on. This might be found further along in the note.

....just some ideas
 
I appreciate the responses from both of you. I wish there was some nugget that I had in the note that would justify even the thought of this being a level 4, but even my boss suggested we may not be able to charge anything.
There is no medical decision making, the patient states "no concerns", we can't even charge for a preventive because there was no exam.
I'm out of ideas...
 
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