Wiki ADD office visit coding for pediatrics

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Truipal

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I am a CPC in pediatric office and we code for a lot of Initial ADD (attention deficit disorder) Evaluations. We are currently coding with a 99215 (established pt) and a charge of $185. The payments that our physicians receive from ins companies are not compensating for the time and detail that are involved with these visits. Does anyone know of another code that could be used that would be a higher allowable or a way to receive more reimbursement for these visits? Thanks!! My docs are very frustrated...:(
 
Prolonged Service

If the physician is spending at least 30 minutes more than the usual time in evaluating the patient you can use the prolonged service codes.

Documentation should indicate total amount of time spent over and above the basic service.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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