Wiki preventive visit ( twice a year)

[jbhuju]

hello all,
need help. can we bill preventive visit twice a year? for example: provider did wellness exam and coded 99396 with DX Z00.00. Then after few days patient came back for Pap Smear and provider coded again 99396 with DX Z01.419, provider just did pap smear no breast exam or other exam on that day. so are not we suppose to bill 99202-99215 for this visit?

please help. thank you

 

[thomas7331]

hello all,
need help. can we bill preventive visit twice a year? for example: provider did wellness exam and coded 99396 with DX Z00.00. Then after few days patient came back for Pap Smear and provider coded again 99396 with DX Z01.419, provider just did pap smear no breast exam or other exam on that day. so are not we suppose to bill 99202-99215 for this visit?

please help. thank you

There isn't a limitation on how many times you can bill the code, but almost all payers will only reimburse this code once per year. Preventive visits aren't recommended or considered necessary more often than this.

However, in the example you're describing, it's not appropriate to bill this code again if there was no exam performed at the second visit. If the only service provided was the pap smear collection, then that's what should be billed. There shouldn't be a separate E&M service billed if none was performed. 99202-99215 are problem-oriented visits and aren't appropriate codes for this situation either.

 

[sls314]

I agree with Thomas. If there was no exam done at the second visit, you wouldn't bill an E/M code.

If the documentation shows that only a pap smear collection was done, then that's what should be billed.