Wiki Annual and IUD Check

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We have a patient who came in for her Annual exam and to check her IUD that was placed 2 months prior. The Physician documented the patient had light spotting for the first week and hasn't had any problems since then. A trans vaginal ultrasound was done to confirm proper placement. Do you think it is appropriate to bill an additional office visit on top of the Annual?
 
I don't think it should be separately billed. Bleeding the first week is typical. If you read the different payer guidelines, this is typically bundled into the annual exam.
 
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