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ladiesnoopy

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:confused:I work for a small independant family practice doctor. She just recently started taking new patients. So far we have had 2 people come in for new patient office visits. These patients have not mentioned anything about "getting established" until in the room with the doctor. They have no immediate or long term problems. They are on no mediciations. I have told my doctor that we can not bill for something that does not have a diagnosis. She suggested billing for "review of personal history." But they do not have any personal or family history of any problems discussed in the visit. She says there has got to be something that we can bill. Any suggestions?? :confused:
 
ladiesnoopy said:
:confused:I work for a small independant family practice doctor. She just recently started taking new patients. So far we have had 2 people come in for new patient office visits. These patients have not mentioned anything about "getting established" until in the room with the doctor. They have no immediate or long term problems. They are on no mediciations. I have told my doctor that we can not bill for something that does not have a diagnosis. She suggested billing for "review of personal history." But they do not have any personal or family history of any problems discussed in the visit. She says there has got to be something that we can bill. Any suggestions?? :confused:
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Is she doing a complete exam, and you're stating there are no complaints whatsoever. Sounds like you'll be looking at possibly a well visit / preventive visit 99381-99397. Otherwise based on what is documented you might be able to bill a 99201-99205.
 
thanks but she is not doing any exam, she is just basically having a conversation with the patient asking if there are any past or current problems. no problems, the patient just wanted to come in and meet the dr to see if she liked her and the office.
 
Necessity

Without medical necessity, does not appear to be billable time. I advise our providers to clearly document discussions with pts. I remind them that "oh, by the way" moments during an office visit. At that point some degree of medical decision making takes place. But again, without such documentation or even medical necessity for the pt to be seen by the provider, don't see any billable time?
 
thanks for the advise. i have told her about it is all in the documentation and she stated that she tried everything to see if there were any problems that the patient might be having so she could come up with some kind of diagnosis. i figured that aapc members would say that if there was no medical decision making then there is nothing to bill but thought maybe if i got something in writing she would believe me. she just keeps stating that there has got to be some way we can bill for my time. hello....who went to coding schooling and who went to doctor schooling....she can do her job and i can do mine!! uugggghhhh frustration!!
 
thanks for all the suggestions. i finally had the office manager email the large hospital organization that will soon be buying our practice. she finally beleived it when they told her the same thing. imagain that??
 
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