Wiki 99391

[lynnefolz]

Does anyone have the guidelines or any information on whether the eye and vision exam are included in the well exam or if they can be billed separately. We are getting conflicting information....
thanks, Lynne

 

[aprein]

As far as I know, they should be bundled into the 99391. But if it's a pediatric patient for Medicaid, it could be different depending on the state you are working in. Who's giving the conflicting information?

 

[dkeown]

Does anyone have the guidelines or any information on whether the eye and vision exam are included in the well exam or if they can be billed separately. We are getting conflicting information....
thanks, Lynne

Reading through the guidelines for the PMS codes I can understand the confusion, especially as related to the eye and vision codes. I too believe that the insurance carrier will be the definitive source for billing. If they don't have an answer, then unless the exam requires more detail than would normally be attributed to an exam, the eye and vision would be considered a component of your PMS code.