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copay question

Annmarie Posted Tue 15th of November, 2011 18:14:56 PM

Please clarify if a copay should be assessed to a patient who was requested to return to the office by their physician for test results THEY did not wish to give over the telephone?? Patient did not request an appointment with the Dr.--instead the Dr. requested his staff make the call to the patient to setup this appointment.

Wouldn't that be included in their original visit that prompted the testing to begin with?

SuperCoder Answered Wed 16th of November, 2011 07:37:50 AM

It depend on the case an CPT. If it is physician's interest to make an appointment with the patient , i think it should fall under follow up, and can't be billed separately.

Annmarie Posted Wed 16th of November, 2011 17:52:30 PM

so do you feel that a copay should NOT have been assessed being that it was at the Dr's request that the patient come in for test results?

SuperCoder Answered Thu 17th of November, 2011 07:57:22 AM

It totally depend upon CPT (procedure) and physician plan of treatment. What was the basic procedure performed at first visit ? and also what is the current lab test? Also what is time duration between first visit and the lab test result?

Annmarie Posted Thu 17th of November, 2011 14:30:43 PM

procedure was a transvag ultrasound that came back needing more views, then a week later another transvag ultrasound & a pelvic ultrasound. That is when the Dr wanted to see the patient as he did not want to give the results over the phone but in person. No other services were offered at that time- ONLY results from the testing were given to patient. No plan of treatment was designated at that time. It all stemmed from patients yearly exam.

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