Wiki Physical w/ office visit

[songstresspyt@yahoo.com]

I'm currently auditing a physician and I'm seeing lots of physicals with office visits for same dos, ex: 99396 99213-25. Do I count the physical exam for the 99396 or the 99213 or both?

 

[MikeEnos]

In that scenario, I generally just count the physical exam towards the 99396 - since it's included. I try to see what I can pull out of the history, and the assessment & plan to count towards the 99213. Remember you're looking for services that are beyond what's included in a normal physical - so if there is a minor/incidental finding that is not significant, or if there is counseling on weight loss, those things are included and not separately billable. If however there is evaluation of multiple chronic conditions, medication management, a new problem that requires a Rx or additional work-up (referral to ortho or derm) that would help support an additional service being billed beyond the preventive visit.

 

[songstresspyt@yahoo.com]

Thanks Mike!!! This helps!