torihamill
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When a patient comes in for a visit to see a GI doc we have them sign a form explaining the difference between a routine visit and problem so they know what to expect if the insurance does not pay and they are responsible for knowing their coverage. The patient is originally coming in for a screening (~age 50). When the patient enters the exam room, he/she discusses the problems they are having and there is nothing said about a routine visit.
The patient then needs the colonoscopy. That is coded as a problem with the 33/PT modifier because the patient's original intent for the visit and procedure was a screening. This is now brought up before the procedure.
The patient comes back and states the visit should be filed as a routine and complains to the doc because there is a copay/deductible applied to the visit. The doc wants to add an addendum to the visit stating it was routine so the patient doesn't have a copay/deductible.
Can/should the doc do this? Visit and procedure are done about a week apart.
Thank you
The patient then needs the colonoscopy. That is coded as a problem with the 33/PT modifier because the patient's original intent for the visit and procedure was a screening. This is now brought up before the procedure.
The patient comes back and states the visit should be filed as a routine and complains to the doc because there is a copay/deductible applied to the visit. The doc wants to add an addendum to the visit stating it was routine so the patient doesn't have a copay/deductible.
Can/should the doc do this? Visit and procedure are done about a week apart.
Thank you