Wiki annual c/u and E&M on same DOS

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dan528i

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Hello, again

We have a new ob/gyn provider in our practice, who states that she is allowed to bill 99384-7 and 99394-7 codes with dx v72.31 if a member is present for regular gyn c/u. HOWEVER, (she also states) that if during a regular c/u the ptn is dx nad treated for UTI and/or BV for example we can bill 99211-5 (folowing E&M guidlines for appropriate level) w/ mod 25 and addition dx codes.
SO ON THE SAME DOS we would bill:
99386 with v72.31 and
99212/3 with 599.0

Can Someone please tell me if this is true ????

THANK YOU.
 
Yes this is true.

As long as documentation supports both services, you can bill a problem visit in addition to the well care.

Laura, CPC
 
katmryn78 said:
Yes this is true.

As long as documentation supports both services, you can bill a problem visit in addition to the well care.

Laura, CPC
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Hey, and I AM back oes again on the same issue.

Is there something in writting i can through into the face of ins comp. That would really make my day. I have Fidelis Care of NY, who paid this cenario for a few months now, telling me that this is NOT allowed. Even though, my first argument was that they habe paid this previously, there current rebutle is that all prious payments were made in error.

CAN SOMEONE please point me towards a link of something from ACOG that I can use to argue my point.

THANKS
 
I don't have anything from ACOG, but if you read the CPT guidelines for Preventive visits, it gives good guidance as to when and how to report a Preventive visit and a problem-oriented one at the same encounter. Best of luck!
 
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