I have a physician that is billing a wellness visit and an established visit on the same date of service. Is this not double billing? I thought that once the wellness visit turned to a problem then code for the problem with an established visit code. Any advise, please.
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Wiki wellness visit and problem visit
- Thread starter Babsss
- Start date
Never mind. I found out that you can bill for both with a 25 modifier. Definitly not encouraged but possible.
cmalone999
Guest
PE and Sick
The practice I work for does it all the time. Just make sure the MD documents both visits.
The practice I work for does it all the time. Just make sure the MD documents both visits.
mitchellde
True Blue
Just remember that as of Oct 1 this practice can no longer be done. The new ICD-10 CM codes do not allow a compliant dx to be use with the annual dx code.
mitchellde
True Blue
Just remember that as of Oct 1 this practice can no longer be done. The new ICD-10 CM codes do not allow a symptom dx to be use with the annual dx code.
barbarat
Contributor
Debra, can you direct me to documentation on that? The state Medicaid program has made no mention of an update to their billing guidelines for Health Checks, and our Peds clinic performs them daily. Thanks!
deenise1221
Guest
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Pediatric billing guidelines
Hello Everyone,
I have recently started working for a pediatric practice but have no experience with coding or billing for this type of specialty. Besides the AAP.org site is there any where else I can go for guidelines or webinars that any of you are aware of?
I do have coding experience just not in this field. In particular where can I find a list of ICD-9 codes that can be billed when a child is scheduled for a well and the visit turns into a sick what icd-9 codes can be billed with the 99211(considered sick codes)? The doc is 99214 for example patient is scheduled for well but Doc addresses obesity can this icd-9 code be considered a sick visit 99213 with the 25 appended to the well?
Also looking for any resources that might help me learn more.
Thanks
Denise
Hello Everyone,
I have recently started working for a pediatric practice but have no experience with coding or billing for this type of specialty. Besides the AAP.org site is there any where else I can go for guidelines or webinars that any of you are aware of?
I do have coding experience just not in this field. In particular where can I find a list of ICD-9 codes that can be billed when a child is scheduled for a well and the visit turns into a sick what icd-9 codes can be billed with the 99211(considered sick codes)? The doc is 99214 for example patient is scheduled for well but Doc addresses obesity can this icd-9 code be considered a sick visit 99213 with the 25 appended to the well?
Also looking for any resources that might help me learn more.
Thanks
Denise
mitchellde
True Blue
The ICD-10 CM information is in the codes themselves, there is an excludes 1 note with the Z00 codes indicating:
Excludes 1 signs and symptoms, code to the signs and symptoms.
Excludes 1 is a pure exclusion note to indicate that you cannot code them together.