Wiki physicals

[TLC]

If a patient comes in for an "office visit" for a problem and they have not seen the doctor in maybe a couple of years. What if the doctor turns the appt into a physical
and bills the physical code and possibly also a E/M code. Should the reason for the appt be changed in the schedule to reflect a physical not an E/M? Also shouldn't it state in the "assessement" that the patient is here for a physical as well as any other dx's? Thanks

 

[ngeorge05]

Preventative codes & Physicals

This was something I have seen very often in my previous place of employment but the other way around. The patient came in for a physical but the doctor did the physical along with addressing their other conditions. What I used to do was bill the regular office visit code along with modifier 25 for the other conditions and then bill the preventative code for the physical. The only issue I believe it created was that a lot of patient insurances cover physicals 100% with no copay but since the patient had other issues taken cared of on the same day as the physical the regular office visit code ruled out the '100% coverage'. This usually upsets the patients and needs to be explained thoroughly to the patient and physician. Hope this helps.

 

[mitchellde]

While this is allowed currently, the ICD-10 CM codes for the general physical Z00.00 for example cannot be coded with signs and symptoms. You are instructed to code only the signs and symptoms which means the physical will need to be rescheduled for another encounter.