Wiki Prevenative Visits

[chavera]

I was asked by one of our physicians if a patient comes in for a full physical and to have the gynecological exam can we bill two preventative visits since it is two differect exams.

 

[ajs]

I was asked by one of our physicians if a patient comes in for a full physical and to have the gynecological exam can we bill two preventative visits since it is two differect exams.

No it is not two different exams, it is a more comprehensive exam as it includes the annual pap, pelvic and breast exam. You can use V70.0 and V72.31 for the dx codes.

 

[berger]

Preventive

It depends are you talking commercial or Medicare, if the patient is Medicare, and you are performing pap and pelvic why wouldn't you bill the G0101 and the Q0091. commercial carriers will consider this bundled into the Preventive visit.

 

[azurere]

Preventative Visits

So Can a family practice who currently is only contracted with commercial payers bill 99395 twice in the same year one for gyn and one for the annual?

 

[Pathos]

In a commercial payer eyes (unless they have a specific benefit that says otherwise), they only pay out the annual physical preventive visit once per year. This includes any male or female specific preventive visits. Medicare plans have a separate code for their Annual Wellness visits and other preventive visit codes which are annual as well.

So in short, no not with commercial unless their benefit policy says otherwise.