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Yearly PE

Karin Posted Sat 16th of June, 2012 01:42:18 AM

My physician saw a patient for a "Day Care PE" and has this same patient scheduled at a later date for her Yearly PE. What e/m code would you assign? Problem focused 99213 or Preventative? You can't bill the prevenative code twice - Right. One more question is if the patient comes to the family practice for her Yearly PE wit you and then sees a specialist OBGYN and they bill a preventative do most payors pay for both Preventative codes since it is by a family MD and a Specialist? Thxs!

SuperCoder Answered Mon 18th of June, 2012 21:23:28 PM

We are in the process. Please be patient.

SuperCoder Answered Tue 19th of June, 2012 06:39:07 AM

Annual wellness visit / annual PE visit can be billed only once a year.

Preventive Medicine E&M services should be reported using the age appropriate code from the Preventive Medicine Services.
Services rendered should be reported using 99381-99387 for new patients or 99391-99397 for established patients.

If an abnormality/ies is encountered, or a preexisting problem is addressed in the process of performing a preventive medicine E&M service, and if the problem/abnormality is significant enough to require additional work to perform the key components of a problem-oriented E&M service, then the appropriate Office/Outpatient code 99201-99215 should also be reported.

Therefore if the "day care PE" visit found some problem/diagnostic condition, then bill an E/M code. You can bill PMS visits more than once a year (that's why New vs. Est. Pt. codes are existing under PMS codes section).

SuperCoder Answered Tue 19th of June, 2012 06:40:35 AM

Yes, you can bill a separate preventive visit with OB-GYN ,and then an annual wellnes visit.

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