Coding for Well Child Visits
Pediatricians perform well baby and well child visits everyday and it is no mystery how to code for these services. Preventive medicine services are billed based on the age of the patient and whether or not the patient is a new or an established patient to the practice. The definition of a new or an established patient is the same if for office visits codes and the preventive medicine services. A new patient is a patient who has not been seen by that physician or by another physician of the s...
According to the Medicare and all physician payer contracts, the medical record for an encounter must be legible. If the documentation is not legible, they are under no obligation to pay for the service, no matter how good the care was, or how sick the patient was.
What should a physician or other provider do if their handwriting is not legible? Print. Use forms. Dictate. Buy an electronic medical record. Use voice activated dictation. Do anything but ignore the issue.
Who decides if it ...
Preventive medicine service and office visit on the same day
Modifier 25 for Preventive medicine service and office visits
The CPT® book describes modifier 25 as the modifier to be used on an E/M service when "a Significant, Separately Identifiable Evaluation and Management Service” is performed by the same physician on the same day of the procedure or other service. Take a moment to read the full description of modifier 25 in your CPT® book.
There are times when a physician provides both a comprehensive preven...