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Pre-Op Exam Done during a Well (Preventive) Visit

Bernadette Posted Mon 03rd of March, 2014 13:39:11 PM


A patient came in for his Preventive visit and needed to also get a medical clearance for tubes surgery. This entailed getting a medical clearance form filled out for the ENT doctor. Normally, when a patient comes in for just a Pre-Op visit, we bill a CPT code 99242 with the V72.84 and exam diagnosis. Would we bill the Preventive CPT code,i.e. 99391, with CPT code 99242 and append a modifier 25 to 99242? Please advise ...

SuperCoder Answered Wed 05th of March, 2014 15:08:47 PM

Instead of billing both codes, you should bill either the consult or the preventive medicine. ln this case, the preventive medicine will be the more comprehensive visit to cover any preoperative issues and would generally have a higher payment, so you should select the appropriate preventive medicine code.

Bernadette Posted Thu 06th of March, 2014 15:24:51 PM

Ok, thank you..

Do I still add the ICD-9-CM codes V20.2,V72.84 and pre-op exam diganosis code all on the 99391 code? Or just the V20.2 ICD-9-CM code?

SuperCoder Answered Thu 06th of March, 2014 16:32:21 PM

Report v20.2 first, and then report the supporting diagnoses (including the pre op one) afterward as supporting diagnoses.

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