Wiki Provider Coding

rpran

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Does anyone have any information on cpt 96110 w/dx V71.89 for Pediatrics? I have been told that this code is bundled into a Preventive Visit code. What are the payers saying. Any information is helpful.
Rhonda
 
They are saying that they feel the service is included in the preventative work up done in the physical. If a seperately identafiable service is documented you may try and resubmit the codes with a /25 on the E&M charge. You will have to submit both codes on a corrected claim. You may need to submit notes to get them paid. I would try without first.
 
Are you doing a preventive visit on the same day? The dx codes are not going to work if you are, The V20.x is first listed only and the V71.xx is first listed only, and is used for a condition that was suspected but not found. I do not see this working in conjunction with a visit for preventive concerns. Just a thought.
 
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