Wiki Preventive Sevices

[Cathy Zardas]

We have a patient who had an annual visit. It was coded as annual without any questions.

She did have at the time a fracture that was workmen's comp and was documented and coded. Everything done that day including labs and xrays was denied stating workman's comp was responsible which of course it wasnt.

Any ideas how to get through this and have the visit paid?

Thank you so much for your help!

 

[teresabug]

although I personally have never experienced this kind of situation, I have read where there should be 2 separate chart notes and hopefully the Dr. documented each service separately. I would appeal at this point. Technically the Dr. should not have treated/reviewed the past fracture and should have had the patient schedule a separate appt so this could have been avoided in the first place.

 

[Leenahz]

I agree with Teresa. Appeal that sucker. The provider may have to do an addendum to the note stating the preventive exam had nothing to do with the W/C case.

Good luck

Marlena