Wiki "get established" office visit

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ladiesnoopy

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We had a new pt come in to "get established" which we do not normally do in our practice. This pt has no past or current medical problems. The dr did not do a physical exam, only took a family history and basic back round information. What dx codeshould be used with cpt 99203? We used V700 but insurance kicked it back stating that it was not valid with that cpt. Please help.:D
 
ladiesnoopy said:
We had a new pt come in to "get established" which we do not normally do in our practice. This pt has no past or current medical problems. The dr did not do a physical exam, only took a family history and basic back round information. What dx codeshould be used with cpt 99203? We used V700 but insurance kicked it back stating that it was not valid with that cpt. Please help.:D
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In order to bill for any new patient visit you must have all 3 key components ( history, exam and MDM) if there is no exam I'm not sure how you are coming up with 99203.
 
I agree. You cannot even get a 99201 without an exam. There was no problem, so no medical neccesity for the visit. I'm guessing the insurance company would frown on paying something that wasn't necessary. Bill the patient. In the future, let the patients who want these visits know up front that they either get a physical, or need a problem to be seen...otherwise they should come in with some cash for the visit...or you limit it to a few minutes to meet the doc as a courtesy to try and grow business.
 
Thanks for the help. I figured that was correct that no OV could be charged but I wanted to verify. I need to get back with our NP and make sure she did not do any exam.
 
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