Forum - Questions & Answers
Internal Medicine
New to billing for Internist, he is currently using all office visit codes even for a full annual exam, can someone tell me if he should be using the code for an annual exam with a v code for the DX? Most of his Pts do have a real DX in addition to the annual exam. How best to bill is the question?
Internal medicine
If the reason for the visit was a physical, you should bill preventive medicin with a V code. If a significant problem is enocuntered, it may be possible to bill a separate E/M code with a 25 modifier and the problem dx.
However even with the modifier, they may not get paid. You need to educate the provider, staff and patients to have separate appointemnets when possible. Otherwise you will likely lose money,
Especially with Medicare patients, routine physicals are not covered with the exception of new beneficiaries
annual exam
If the patient has a chronic condition and requires management of the chronic condition (meds, labs, x-rays, etc), it is a medically necessary encounter.
If the patient is asymptomatic, no complaints and is having a full physical/age specific, it is a preventive encounter (V code). It is difficult to tell without looking at the note.
-25 are getting paid
We are having good luck getting paid on Physicals and E&M together with the -25 on the E&M. We are being sure to separate the assessment and plan for each part to clearly differentiate the work involved with the physical and the work with the E&M problem. So...PE- wear seat belt, exercise, lose weight. HTN- Check EKG, start Lisinopril, low salt diet, return 1 month