Wiki Follow up visits and review of results

[adrig]

Hello,

I’ve received conflicting answered so I’m hoping to get more clarity here.

We have patients that come in for review of results. I understand if treatment plan does not change and nothing notable was done in the visit to warrant a charge, we do not bill the insurance for the visit.

However there are times where the providers spend up to 45-60 minutes with a patient and most often visits end with new medications prescribed or prescription refill, referrals to specialists, additional requests for tests etc. In this instances is it ok to bill a low level office visit if the providers is still completing additional work other than a simple review of results?

Please help in any way you can.

Thank you.

 

[jkyles]

Hi there, I would say it is OK to bill the appropriate E/M visit for the second example. It might be low level, it might be higher, it just depends on the documented MDM or time. Perhaps I'm missing something but I don't see where there's room for conflict here.